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1、老年危重症死亡病例42例分析王丽娜陈洋林志能王波梁景岳范陈豪(美)(通信作者)(浙江省台州市路桥IX第二人民医院内科318058)【摘要】目的分析当前老年内科危重症病例的病情特点和死亡原因,为提高医护人员的救治水平积累经验。方法收集入院后60岁以上老年人因各种原因救治无效的死亡病例42例,通过对入院诊断、检查、治疗和病情恶化后抢救过程、死亡原因等方面的分析,讨论和总结死亡病例的特点、救治经验以及有待改进的知识和技术。结果在两年中住我院内科总病例数为4312例,抢救病例517例,住院期间死亡的老年人42例,死亡人数占入院总人数的0.97%。其
2、中入院后24小时内死亡者14例,占死亡病例的33.3%,其余大部分在入院两周内死亡。死亡主要原因有猝死(12例,28.6%),脓毒症(9例,21.4%),心肌梗死(3例,7.1%),窒息(5例,11.9%),跌倒(3例,7.1%),肺栓塞(3例,7.1%),脑岀血(3例,7.1%),代谢紊乱(5例,11.9%)。结论应加强老年人危重症患者在急诊和入院时的快速诊断和处理能力,入院后的监护措施和系统分析、处理方法应规范化,防止意外事件的发生需从加强护理入手。【关键词】老年人危重症死亡分析【中图分类号】R592【文献标识码】A【文章编号】2095
3、-1752(2014)23-0015-03AnalysesofDeathinFortyTwoElderlyCriticalPatientsWANGLina,CHENYang,LINZhineng,WANGBo,LIANGJingyue,FANChenhaoDepartmentofInternalMedicine,TheSecondPeople’sHospitalofLuqiaoDistrict,TaizhouCity,ZhejiangProvince318058,China【Abstract】Objective:Inordert
4、oimproveresuscitationandmanagementskills^andaccumulateexperienceformedicalstaff,thecharacteristicsandcausesofdeathintheelderlycriticalpatientswereanalyzed.Methods:Fortytwocasesoftheelderlyabove60yearsofagewhodiedafteradmissionwerecollected.Basedonanalysesofadmissiondiagnos
5、is,check-up,medicaltherapy,resuscitationafterthedeteriorationandcausesofdeath,thecharacteristicsofthediseases,thelessonsandexperienceduringthetreatment,theknowledgeandtechnicsduringthecarewhichneedtobeimprovedwerediscussedandsummarized.Results:Thetotalnumberofadmittedpatie
6、ntsinthetwoyearswas4312.Amongthem,517caseshadcriticalconditionsandreceivedlifesavingprocedures.42casesweredeadandmortalitywas0.97%inthetotalpatients.Indeadpatients,14casesdiedwithin24hoursafteradmission,whichaccountedfor33.3%.Therestofpatientsmostlydiedintwoweeksafteradmis
7、sion.Themajorcausesofdeathweresuddendeath(12cases,28.6%),sepsis(9cases,21.4%),myocardialinfarction(3cases,7.1%),suffocation(5cases,11.9%),fall(3cases,7.1%),pulmonaryembolism(3cases,7.1%),intracranialhemorrhage(3cases,7.1%),metabolicdisorders(5cases,11.9%).Conclusion:Theski
8、llsofrapiddiagnosisandmanagementduringemergencyandonadmissionshouldbeenhanced.Themonitori