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目的:分析一般综合性医院急诊科的肿瘤急症的特点,探讨其救治措施。方法:对我院急诊科1997-2006年收治留观的肿瘤急症患者的临床资料进行统计分析。结果:本组197例,77.7%入院前已诊断患有肿瘤。恶性肿瘤占98.0%。经急诊治疗后好转93例(47.2%),死亡50例(25.4%)。发生急症的肿瘤主要有肺癌(57.9%)、肝癌(5.1%)、直肠癌(5.1%)等。肿瘤急症常表现为感染(37.1%)、疼痛(11.2%)、出血(10.2%)等。67.7%外周血白细胞总数升高,最常见的是肺部感染。血象升高的患者中发生死亡的比例高于血象正常的患者(P<0.01)。57.0%出现贫血,多属于轻～中度,常见发生贫血的是肺癌(57.5%)、消化系统肿瘤(29.2%)。肿瘤急症的急诊处理主要是内科治疗,只有1.6%进行了急诊手术治疗。结论:随着恶性肿瘤的发病率、死亡率增加及癌症生存者人群迅速增长,急诊医师应加强对肿瘤急症的认识,及时处理,避免危及生命,也为以后的治疗争取时间、提供机会。
Objective: To analyze the characteristics of emergency of general hospital emergency department and discuss its treatment measures. Methods: The clinical data of patients with acute cancer admitted to our emergency department from 1997 to 2006 were statistically analyzed. Results: The group of 197 cases, 77.7% had been diagnosed with cancer before admission. Malignant tumors accounted for 98.0%. After emergency treatment, 93 patients (47.2%) improved and 50 patients died (25.4%). Emerging tumors are mainly lung cancer (57.9%), liver cancer (5.1%), rectal cancer (5.1%) and so on. Tumor emergency often manifested as infection (37.1%), pain (11.2%), bleeding (10.2%) and so on. 67.7% increase in the total number of peripheral white blood cells, the most common is a lung infection. The proportion of deaths in patients with elevated blood was higher than in patients with normal blood (P <0.01). 57.0% were anemic, mostly mild to moderate, and common anemia was lung cancer (57.5%) and digestive system tumors (29.2%). The emergency treatment of cancer emergency treatment is mainly medical treatment, only 1.6% of emergency surgery. CONCLUSIONS: With the increase of the incidence and mortality of malignant tumors and the rapid increase of cancer survivors, emergency physicians should strengthen the understanding of cancer emergency, timely treatment, avoid life-threatening, and strive for the time for future treatment.