成人吸入性窒息临床特点分析

Analysis on clinical features of adult aspiration asphyxia

目的分析成人吸入性窒息发病及预后相关特征。方法对2005年1月—2012年6月我院成人吸入性窒息病例误吸前慢性病、误吸原因、误吸时意识状态、吸入异物、误吸后病情严重程度及生存日数等资料进行回顾性分析。结果纳入患者32例,男26例,女6例。平均年龄(60.31±24.80)岁。急性期病死率34.4%,误吸前慢性神经系统疾病患病率65.6%,循环系统疾病患病率62.5%。84.4%误吸发生于意识障碍中,87.5%吸入胃内容物。急性期死亡组(11例)与存活组(21例)比较,误吸前神经系统及循环系统疾病患病率高、慢性病累及系统数多,误吸当日首次抢救后急性生理学及慢性健康状况评分Ⅱ分值高(P<0.05)。结论成人吸入性窒息多发生于老年男性,多见于意识障碍中胃内容物反流,急性期病死率高,预后不良与神经系统及循环系统患慢性病有关。

Objective To investigate the clinical features of the development and prognosis of aspiration asphyxia in adults. Methods A retrospective review was carried out on adults with aspiration asphyxia hospitalized in the hospital from January 2005 to June 2012. Data were collected, including chronic diseases before aspiration, causes of aspirations, status of consciousness at the point of aspiration episode, aspirated materials and severity of patients＇ conditions after the episode. Results Thirty-two patients （26 males, 6 females） , with an average age of （60.31 ± 24.80）years, were included. The mortality at acute phase was 34.4%. The most prevalent chronic diseases before aspiration were nervous disease （65.6%） and circulatory disease （62.5%）. Aspiration took place mostly in the condition of consciousness disorder （ 84.4% ）. The main aspirated material （ foreign body） was gastric contents （87.5%）. Compared with those survived acute phase （ n = 21 ） , the victims died at acute phase （ n = 11 ） had a higher prevalence of chronic nervous disease and circulatory disease, more chronically ailing systems before aspiration, and a higher score by acute physiology and chronic health evaluation Ⅱ after the first salvage （P 〈 0.05）. Conclusion In adults, old males are sub- ject to aspiration asphyxia, which has a high mortality in acute phase. Aspiration takes place mostly in the condition of conscious-ness disorder. Bad prognosis is related to chronic diseases in nervous and circulatory systems.