2011年上海市嘉定区院前急救死亡病例调查分析

The investigation and analyses on dead cases in pre-hospital emergency medical care in Jiading district of Shanghai in 2011

目的调查上海市嘉定区院前急救死亡病例的情况，探讨其院前死亡病例的特点，为提高院前急救的心肺复苏（CPR）能力提供科学依据。方法收集整理2011年嘉定区医疗急救中心收治的死亡病例，对有完整记录的资料进行统计学分析。结果①2011年本区院前急救总病例为16185例，其中死亡病例451例（2．8％），男性院前死亡数明显多于女性。②主要死因为循环系统233例（51．66％），损伤和中毒138例（30．60％），肿瘤32例（7．10％）；造成死亡病因构成比方面男女之间比较差异无统计学意义（P〉0．05）。③死亡病例的高发年龄段为≥65岁；男女病例在〈65岁各年龄段构成比之间比较差异有统计学意义（均P〈0．05）。④该组病例的24h发病高峰在18：00—20：00，月份发病高峰为1月份，在每次季节交替前1个月份均出现1次发病的相对高峰，发病的季节高峰为冬季。⑤从症状发现到呼叫120的间隔时间平均为（29．96±26．10）min；急救反应时间平均为（9．89±5．93）min。⑥435例（96．45％）在急救医生到达现场时心搏、呼吸已停止，只有22例（4．88％）在院前急救医务人员赶到现场之前给予了CPR，其中现场CPR成功5例（1．11％）。结论加强全民健康教育、普及全民CPR知识和技能，尽早发现、预防和干预危及生命的疾病或症状，提高院前急救从业人员专业技术水平，对于提高院前CPR成功率具有重要意义。

Objective To investigate the situation and characteristics of pre-hospital dead cases in Jiading district of Shanghai to provide a scientific basis for improving the success rate of cardiopulmonary resuscitation （CPR） in pre-hospital medical care. Methods Data of pre-hospital dead cases in 2011 were collected from Jiading District Medical Emergency Center. The thorough records of such cases were subjected to statistical analyses. Results ① In a total of 16 185 cases of pre-hospital care in 2011, there were 451 deaths （2.8%）, males being the predominant. ② The main causes of pre-hospital deaths were as follows ： 233 cases （51.66%）due to circulatory system diseases, 138 cases （30.60%）trauma and poisoning, and 32 cases （7.10%） tumor, there were no significant differences in the causes between male and female （P〉0.05）. ③The age with highest incidence of deaths was ≥65 years old, and the differences between male and female in various age group of 〈65 years old were significant （all P〈0.05）. ④ The peak of pre-hospital deaths occurred most frequently in January of the year, or the seasonal peak of onset was in winter, especially within one month before a seasonal alternation ; the peak of death in a day was in the period of 18 ： 00-20 ： 00. ⑤ The average intermittent time between the discovery of a patient＇s symptoms and making an emergency call （number 120） was （29.96 ± 26.10） minutes, and the average emergency reaction time or the duration from the first aid station to the first aid spot was （9.89 ± 5.93）minutes. ⑥Cardiopulmonary arrested had been found in 435 cases, accounting for 96.45%, when the pre-hospital medical workers arrived at the spot, and only had 22 cases （4.88%） undertaken CPR before they took medical care. Five cases obtained successful medical care personnel＇s CPR, the success rate being 1.11%. Conclusion It is very important to strengthen the health education and popularize the knowledge and skills of CPR among the whole people in the country, to discover, prevent and intervene the life- threatening diseases or symptoms as early as possible, and to improve the first aid employees professional skills in order to elevate the success rate of CPR during the pre-hospital medical care.