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目的采用随访研究的方法收集急诊科昏迷病人病因及主要的预后影响因素,为今后临床工作提供参考。方法采用随访研究的方法收集某院急诊科2011年1月到2013年4月收治的332例昏迷的患者作为研究对象,其中男性184例(55.4%),女性148例(44.6%),年龄为22~76岁,平均年龄为(45.4±4.6)岁。急诊昏迷主要的疾病为脑血管疾病、中毒、严重创伤、糖尿病疾病,分别占38.6%、34.6%、14.2%和7.5%。发病后入院时间≥1 h与<1 h相比,预后明显较差,HR(95%CI)为2.71(1.11~7.55)。重度昏迷与轻度昏迷相比,预后效果也较差,HR(95%CI)为2.84(1.02~10.0)。结论本研究主要的目的在于了了解急诊患者昏迷的病因及预后影响因素,研究发现昏迷原因是由脑血管疾病导致,而患者昏迷成度和发病后入院时间均是患者预后的主要因素。
Objective To investigate the etiology and major prognostic factors of patients with unconsciousness in emergency department by follow-up study and provide references for future clinical work. Methods A follow-up study was conducted in 332 cases of coma admitted to the emergency department of a hospital from January 2011 to April 2013. Among them, 184 (55.4%) were male and 148 (44.6%) were female, with a mean age of 22 to 76 years old, the average age was (45.4 ± 4.6) years old. The main diseases of emergency coma were cerebrovascular disease, poisoning, severe trauma and diabetes, accounting for 38.6%, 34.6%, 14.2% and 7.5% respectively. After admission onset time ≥ 1 h compared with <1 h, the prognosis was significantly worse, HR (95% CI) was 2.71 (1.11 ~ 7.55). Severe coma compared with mild coma, the prognosis is poor, HR (95% CI) was 2.84 (1.02 ~ 10.0). Conclusions The main purpose of this study is to understand the etiology and prognostic factors of coma in emergency patients. It is found that coma is caused by cerebrovascular disease, and coma and post-illness admission are the main prognostic factors.