急诊猝死流行病学特征及心肺复苏效果分析

Research of sudden death characteristics and clinical analysis of cardiopulmonary resuscitation

目的 分析急诊猝死流行病学特征并探讨心肺复苏对急诊猝死患者的急救效果。方法 回顾性分析2012年1月-2015年12月于北京市大兴区人民医急诊科救治的150例急诊猝死病例的临床资料,从猝死患者的性别、年龄、既往史、猝死前先兆症状、诱因、猝死发生场所、猝死发生季节及时间等方面分析猝死的流行病学特征,分析猝死的心肺复苏效果。结果 150例急诊猝死患者中,男性明显多于女性,60-79岁发生率明显高于≤39岁、40-59岁、≥80岁年龄段,既往有心血管病史者发生率明显高于脑血管病史、糖尿病史,有先兆症状者明显高于无先兆症状者,有明确诱因明显高于无明确诱因者,冬春季明显高于夏秋季,差异有统计学意义（P均〈0.05）。从急诊猝死发生的具体时间分布分析,4-12时是急诊猝死发生的高峰期,随后总体呈现出下降趋势,16-20时又小幅升高。0-4时是猝死发生率最低的时间段。150例猝死患者中,142例为院外猝死,仅11例患者得到了现场目击者第一时间心肺复苏救治,共复苏成功5例,复苏成功率3.33%（5/150）。结论 急诊猝死以中老年男性为主,心脏性猝死是主要原因。现场第一目击者就地进行心肺复苏,结合专业人员除颤及药物对症治疗可提高猝死的复苏成功率。

Objective To investigate the effect of cardiopulmonary resuscitation in emergency treatment of sudden death. Methods The clinical data of 150 emergency death patients from January 2012 to December 2015 in People＇s Hospital of Daxing District were retrospectively analyzed, epidemiological information including： gender, age, previous history of sudden death in patients with aura symptoms before sudden death, incentives, workplace, season occurrence and time characteristics of sudden death, and clinical effect of cardio-pulmonary resuscitation（CPR） was also analyzed. Results Among those patients, number of males was higher than that of females. The incidence of sudden death was higher in patients of following groups： between 60~79 years old, had history of cardiovascular disease, had premonitory symptom or with known risk factors; and it was higher in winter and spring than other seasons（P〈0.05）. As to the time distribution, 4~12 o＇clock was the peak time of sudden death, following a slight increasing during 16~20 o＇clock, and 0~4 o＇clock was the time of lowest incidence. 142 patients had prehospital sudden death, 11 of them received CPR at the first time by witness at the scene, only 5 patients survived after CPR（3.33%, 5/150）. Conclusion Emergency treatment of sudden death is usually given priority to middle-aged male-dominated, sudden cardiac death is the main reason. Cardiopulmonary resuscitation of the first responder on the spot combined with professional defibrillation and drug symptomatic treatment can improve the success rate of recovery of sudden death.