75例猝死的临床病理分析

Clinical and pathological Analysis of Sudden Death in 75 cases

目的探讨猝死的病因、病理基础及防治措施。方法回顾性分析我院75例猝死的临床病理资料。结果 75例猝死中,老年人47例,占62.7％,非老年人28例,占37.3 ％,男女之比约3:1。心原性猝死52例,其中冠心病猝死36例,占69.2％(36/52);非心原性猝死19例,其中以急性出血坏死型胰腺炎所占比例最高42.1％(8/19);4例尸检病理检查未见致死性疾病。冠心病猝死患者主要建立在冠状动脉多支严重病变基础上。结论猝死以老年男性多见,有广泛严重冠状动脉病变的冠心病者猝死发生率高。防治冠心病、改善心肌缺血等综合治疗十分必要。胰源性猝死主要为急性出血坏死型胰腺炎所致,误诊率较高。猝死可发生在无器质性疾病的正常人,应加强心理素质训练。

Objective To study the clinical and pathological bases, the cause and preventive treatment. Methods Retrospectively analyzed theclinical and pathological material of sudden death in 75 cases in our hospital. Results In 75caaes of sudden death, included 47 old people, 57 male and 18 female (3: 1). 52 cases of sudden cardiac death in 75 cases were studied (69.3 % ) . including 36 cases died of coronary heart disease f 36/52) . Most of them had serious atherosclerotic stenosis of the coronary artery with multiple branches involved. The primary cause in 19 cases of sudden non - cardiac death was hemorrhagic necrotic pancreatitis (42.1 % ) . Conclusions we conclude that sudden death frequently occur in old men with severe multiple branches atherosclerotic stenosis of the coronary artery. It is necessary to prevent coronary heart disease and improve myocardjal ischemia. The main characteristics of sudden pancreatogcnic death, which has high misdiagno-sis rate, are the acute hemorrhagic necrctic variety. As the findings show that sudden death can also occur in normal person without organic disease, the psychological train should be intensified.