Ishizaki A, Shinozaki M, Yoshida R, Kurata K, Sakamoto K, Shinohara T, Sasaki H, Sato J, Morimatsu Y
Metropolitan Medical Center of Severely Handicapped, Fuchu.
No To Hattatsu. 1990 Jul;22(4):357-63.
Among 848 cases of profound mental retardation with motor disturbance admitted to Metropolitan Medical Center of Severely Handicapped in the last 20 years, 98 died. The 94 cases whose cause of death was determined were clinically investigated. There was no difference in sex, and 72% of the patients died before the age of 15 years. Half of the patients died of pneumonia; sudden death occurred in 9, and ileus in 8. These three were thought to be the most important and characteristic causes of death in severely handicapped patients. In recent years, deaths due to pneumonia have decreased and those due to ileus have disappeared, but deaths due to malignant neoplasm have begun to be recognized. There were also some deaths from intracranial hemorrhage in young children, and some deaths from tracheal bleeding in those who had tracheal tubes. These two were also important causes of death in the patients. Sudden death had certain characteristics: most cases were adolescent or young patients with mixed quadriplegia who were sensitive to environmental changes and often showed marked hypertonia by athetosis, and in addition, all of their acute changes occurred between 5 and 8 a.m. or between 6 and 9 p.m.
在过去20年里入住重度残疾者首都医疗中心的848例伴有运动障碍的重度智力迟钝患者中，98例死亡。对94例死因已明确的病例进行了临床调查。在性别上没有差异，72%的患者在15岁之前死亡。一半的患者死于肺炎；9例猝死，8例死于肠梗阻。这三种情况被认为是重度残疾患者最重要和最具特征性的死因。近年来，肺炎导致的死亡有所减少，肠梗阻导致的死亡已经消失，但恶性肿瘤导致的死亡开始被认识到。也有一些幼儿死于颅内出血，一些气管插管患者死于气管出血。这两种情况也是患者的重要死因。猝死有一定的特点：大多数病例是患有混合型四肢瘫痪的青少年或年轻患者，他们对环境变化敏感，常因手足徐动症而表现出明显的肌张力亢进，此外，他们所有的急性变化都发生在凌晨5点至8点之间或下午6点至9点之间。
