Ueda N, Kitade M, Moritaka T, Nakanishi N
Department of Internal Medicine (For Respiratory Disease), Ehime Prefectural Central Hospital, Matsuyama, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Dec;32 Suppl:31-8.
We studied treatment for respiratory emergencies over the past 11 years at our hospital, a tertiary emergency center. We supply intermediate management services to a general hospital. A total of 13,667 patients received tertiary emergency medical care (annual mean: 1243). Of these, 1592 had severe respiratory disturbances (11.5% of the total; 971 males, 621 females; annual mean: 143). The most frequently seen conditions were COPD, respiratory failure due to old pulmonary tuberculosis) 35.2%, mortality failure due to old pulmonary tuberculosis (35.2%, mortality rate: 29.7%), bronchial asthma (26.0%, mortality rate 9.6%), pneumonia (19.0%, mortality rate 20.4%), and pneumothorax (10.3%). Very few of the patients with bronchial asthma who arrived in cardiopulmonary arrest survived. Patients with interstitial pneumonia, paraquat lung, pulmonary obstruction, adult respiratory distress syndrome, and near-drowning all had poor prognoses, as did victims of attempted suicide by hanging and attempted murder by strangulation. About 25% of the patients required mechanical ventilation, and about half of those patients died. Changes in prehospital care and in care given after critical care is no longer needed are important in improving the prognoses for patients with respiratory emergencies.
我们研究了过去11年在我院（一家三级急救中心）对呼吸急症的治疗情况。我们为一家综合医院提供中级管理服务。共有13667名患者接受了三级紧急医疗护理（年均：1243例）。其中，1592例有严重呼吸障碍（占总数的11.5%；男性971例，女性621例；年均：143例）。最常见的病症为慢性阻塞性肺疾病、陈旧性肺结核所致呼吸衰竭（35.2%，死亡率：29.7%）、支气管哮喘（26.0%，死亡率9.6%）、肺炎（19.0%，死亡率20.4%）和气胸（10.3%）。到达时心跳呼吸骤停的支气管哮喘患者存活者极少。间质性肺炎、百草枯肺、肺梗阻、成人呼吸窘迫综合征和近乎溺水的患者预后均较差，上吊自杀未遂和勒杀未遂的受害者也是如此。约25%的患者需要机械通气，其中约一半患者死亡。院前护理以及在不再需要重症护理后所提供护理的变化，对于改善呼吸急症患者的预后很重要。
