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目的:分析急诊内科昏迷病人临床特征,分析预后影响因素,总结救治经验。方法:2013年1月~2015年12月,医院急诊内科共收治328例,调取患者病历资料,进行回顾性分析,将死亡患者纳入死亡组,存活患者纳入存活组,进行因素分析。结果:男女比例1.98:1.00,脑出血21.6%、低血糖19.2%、脑梗死10.4%、乙醇中毒6.7%、,不同男性、年龄段病种分布差异具有统计学意义(P<0.05);发病至就诊时间25min~11h、平均(4.2±1.2)h。入院明确诊断时间30min~32h、平均(2.5±1.0h);死亡率25.3%;死亡者脑出血、重度昏迷率高于存活者,低血糖、急诊科苏醒率、有自救措施率低于存活者,死亡者年龄、发病致就诊时间、明确诊断时间高于存活者,差异具有统计学意义(P<0.05)。结论:急诊内科昏迷以脑血管病、代谢或中毒为主,病谱与患者年龄、性别存在相关性,死亡率高,死亡影响因素较多。
OBJECTIVE: To analyze the clinical features of emergency coma patients, analyze prognostic factors, and summarize the experience of treatment. Methods: From January 2013 to December 2015, a total of 328 emergency medical departments were enrolled in the hospital. The medical records of patients were retrieved and analyzed retrospectively. The dead patients were included in the death group and the survivors were included in the survival group for factor analysis. Results: The ratio of male to female was 1.98: 1.00, cerebral hemorrhage was 21.6%, hypoglycemia was 19.2%, cerebral infarction was 10.4%, and alcohol poisoning was 6.7%. There was significant difference in the distribution of disease between different male and age groups (P <0.05) Treatment time 25min ~ 11h, an average of (4.2 ± 1.2) h. The average diagnosis time was 30min ~ 32h (mean 2.5 ± 1.0h); the death rate was 25.3%; the rate of death from hemorrhage and severe coma was higher than that of survivors, hypoglycemia and emergency department, and the self-help rate was lower than that of survivors , The age of the deceased, the time of onset of the illness, the definite diagnosis time was higher than that of the survivors, the difference was statistically significant (P <0.05). Conclusion: The coma of emergency department is mainly caused by cerebrovascular disease, metabolism or poisoning. The disease spectrum is related to the age and sex of patients, the mortality rate is high, and there are many factors of death.