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目的调查广州市院前死亡患者流行病学情况,探讨院前死亡病例特点。方法从广州市急救医疗指挥中心系统数据库中导出2008年度全部死亡数据进行统计分析。结果院前非心脏性猝死与院前心脏性猝死患者均以白云区最多,其次是海珠区、其他区。院前非心脏性猝死组调度时间、到达时间、院前急救总时间均少于院前心脏性猝死组(P<0.01),分别为调度时间(2.69±1.24)min vs(2.85±1.29)min,到达时间(11.28±5.57)min vs(12.72±6.43)min,院前出车总时间(42.97±20.68)min vs(44.96±21.18)min,院前非心脏性猝死组的现场时间和急救半径多于院前心脏性猝死组(P<0.05或<0.01),现场时间(18.99±7.96)min vs(17.53±7.52)min,急救半径(6.52±3.26)km vs(6.29±3.16)km。院前非心脏性猝死与院前心脏性猝死患者均以1~3月和8:00~10:00最多。在5 525例院前死亡中,其他类的死亡位居第一,循环系统(尤其是心脏性猝死)、呼吸系统、神经系统类的死亡分别位居第二、第四、第五,创伤类的死亡位居第三,>70岁年龄段死亡最多。男性院前总死亡与院前心脏性猝死均明显高于女性。结论院前死亡患者的病情复杂,出车医师难以在短时间内明确诊断,加强这方面工作极为重要。心脏性猝死与创伤死亡分别以中老年、青壮年阶段为高发,并已成为院前死亡的主要原因。
Objective To investigate the prevalence of prehospital deaths in Guangzhou and to explore the characteristics of prehospital deaths. Methods The data of all the deaths in 2008 were derived from the system database of Guangzhou Emergency Medical Command Center for statistical analysis. Results The pre-hospital non-cardiac sudden death and pre-hospital sudden cardiac death were the most in Baiyun District, followed by Haizhu District and other districts. The dispatch time, the arrival time and the total pre-hospital emergency time in pre-hospital non-sudden cardiac death group were all less than those in pre-hospital sudden cardiac death group (2.69 ± 1.24) min vs (2.85 ± 1.29) min , The time of arrival (11.28 ± 5.57) min vs (12.72 ± 6.43) min, the total time before hospital departure (42.97 ± 20.68) min vs (44.96 ± 21.18) min, the pre-hospital non-cardiac sudden death group (18.99 ± 7.96) min vs (17.53 ± 7.52) min, and the emergency rescue radius was (6.52 ± 3.26) km vs (6.29 ± 3.16) km, respectively. Pre-hospital non-cardiac sudden death and pre-hospital sudden cardiac death in patients with 1 to 3 months and 8: 00 ~ 10: 00 most. Of the 5 525 pre-hospital deaths, deaths of other types ranked first, and the death of the circulatory system (especially sudden cardiac death), respiratory system and nervous system ranked second, fourth and fifth respectively, and trauma Of the deaths ranked third,> 70-year-old most dead. Male pre-hospital deaths and sudden cardiac death were significantly higher than women. Conclusions Patients with pre-hospital death are in a complicated condition and it is very difficult for a taxi-out doctor to make a definite diagnosis within a short period of time. It is extremely important to strengthen this work. Cardiac sudden death and traumatic death, respectively, in the middle-aged and young adults were high incidence, and has become the leading cause of pre-hospital death.