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目的:探讨急诊科死亡原因及规律,为防治死亡提供科学依据和对策。方法:回顾性分析广西医科大学一附院东院急诊科2003年1月～2008年12月在院前及急诊科抢救无效死亡728例的资料。结果:总体死因顺位是猝死(22.3%)、损伤(13.2%)、心血管疾病(11.8%)和机动车意外伤(10.0%),男性72.3%(526/728),死亡时间以辰时(7～9时)、戌时(19～21时)、巳时(9～11时)和寅时(3～5时)较集中;院前死亡54.4%(396/728),前三位为猝死(31.3%)、损伤(13.8%)、心血管病(12.1%);儿童以心血管疾病、呼吸、恶性肿瘤为前三位死因,中青年以创伤(包括损伤和机动车意外伤)、猝死为主,老年人以猝死、心脑血管疾病为主要死因,各年龄段比较差异有统计学意义(P<0.01)。结论:重视猝死、创伤和心脑血管等常见急诊致死性疾病的生命支持,在死亡集中时间段提高警惕,熟练地开展心肺复苏;提高严重创伤的现场救治能力和急诊常见病多发病抢救水平;提高公众急救意识和急救电话120的知晓率,普及全民徒手心肺复苏技术,提高公众自救互救能力;在生产过程中贯彻预防为主、安全生产的方针,可降低急诊死亡率。
Objective: To investigate the causes and laws of death in emergency department and provide scientific basis and countermeasures for preventing and curing death. Methods: The data of 728 cases of ineffective death in hospital and emergency department from January 2003 to December 2008 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Results: The overall cause of death was sudden death (22.3%), injury (13.2%), cardiovascular disease (11.8%) and motor vehicle accidental injury (10.0%), males 72.3% (526/728) (9 to 11 o’clock) and Yin (3 to 5 o’clock); 54.4% (396/728) died before hospitalization, and the first three were sudden death (31.3 %), Injury (13.8%), cardiovascular disease (12.1%); children with cardiovascular disease, respiratory and malignant tumors as the top three causes of death, young and middle-aged trauma (including injury and motor vehicle accidental injury), sudden death , The elderly died of sudden death, cardiovascular and cerebrovascular diseases as the main cause of death, the difference was statistically significant in all age groups (P <0.01). CONCLUSION: Life support for common emergency fatal diseases such as sudden death, traumatic injury and cardiovascular and cerebrovascular diseases are emphasized, and vigilance and proficiency in cardiopulmonary resuscitation are performed during the concentrated period of death; the on-the-spot rescue ability of severe trauma and emergency treatment of frequently-occurring emergencies are increased; Improve public awareness of emergency first aid and call 120, popularize universal freehand cardiopulmonary resuscitation techniques and improve public self-help and mutual-help capacity; and implement prevention-oriented and safe production guidelines in the production process to reduce the emergency mortality rate.