180例昏迷病人病因分析及内科急诊抢救体会

Etiologies of coma in 180 patients and experience on emergency medical treatment

目的探讨本院急诊内科收治的180例昏迷病人的病因及抢救措施。方法回顾性分析本院收治的180例昏迷病人的临床资料，分析其疾病构成、抢救成功率及有效的抢救措施。结果180例患者中，抢救成功170例，抢救成功率94．4％；脑血管病80例（44．4％），急性中毒69例（38．3％），糖尿病昏迷18例（10．0％），继发性脑部病变7例（3．9％），其他6例（3．3％）；死亡10例患者中，脑血管病5例（50．O％），急性中毒3例（30．0％），糖尿病2例（20．0％）。结论急诊内科昏迷最常见的病因包括脑血管疾病、急性中毒、糖尿病等疾病，临床医生应准确诊断病因，并针对病因及时抢救。

Objective To explore the etiologies of coma in 180 patients and the relevant emergencytreatments. Methods The clinical data on 180 coma patients who had been treated in our hospital were retrospectively analyzed. The causes of coma, success rate of the therapies, and effective treatment measures were analyzed. Results 170 of the 180 patients were successfully rescued, with a rate of 94.4%; Of the 180 patients, 80 （44.4%） were due to cerebrovascular diseases, 69 （38.3%） were acute poisoning, 18 （10.0%） were diabetic coma, 7 were secondary brain lesions （3.9%）, and 6 （3.3%） were due to other etiologies. Among the 10 dead patients, 5 （50.0%） suffered from cerebrovascular diseases, 3 （30.0%） suffered from acute poisoning, and 2 （20.0%） suffered from diabetes coma. Conclusions The most common causes of coma in the emergency department are cerebrovascular diseases, acute poisoning, and diabetes. Clinicians should diagnose the causes of coma accurately and administer timely rescue based on the causes.