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[临床研究在脑死亡诊断中的价值与无价值]

[Value and worthlessness of clinical studies in the diagnosis of brain death].

作者信息

Schneider D, Baumann I, Köhler H

出版信息

Z Gesamte Inn Med. 1976 Jan 15;31(2):29-37.

PMID:960884
Abstract

Death was ever determined on the basis of extinguished partial functions of the entire organism (partial death). In intensive medicine with its possibilities of reanimation, with its possibilities of artificial maintenance of breathing and circulation the individual death of man is equated with his cerebral death. It comes only under conditions of reanimation and nearly always shows a clinically recognizable development. Practically above all "the syndromes in the forefield of cerebral death" are of interest as well as its obligatory and optional symptoms, the valency of which was critically tested. A 5-year-analysis (1969 to 1973) of 487 deaths in an internal intensive therapy unit (18% of mortality) was shown that causes, frequency and age distribution of the mortal conditions of disease as well as the average survival time of 4.5 days, in which cases, however, 43% of all deaths occurred within the first 24 hours, very rarely caused us to establish the irreversibility of the loss of the cerebral function on account of an organic dysfunction, but rather resulting from the question of the interruption of an absurd reanimation.

摘要

死亡一直是根据整个机体部分功能的消失(部分死亡)来判定的。在有复苏可能性、有人工维持呼吸和循环可能性的重症医学中,人的个体死亡等同于脑死亡。它仅在复苏情况下出现,并且几乎总是呈现出临床上可识别的发展过程。实际上,最重要的是“脑死亡前期的综合征”以及其必有的和可选择的症状都备受关注,其有效性也经过了严格检验。对一个内科重症治疗病房487例死亡病例(死亡率为18%)进行的为期5年(1969年至1973年)的分析表明,疾病致死状况的原因、频率和年龄分布以及平均存活时间为4.5天,然而,在所有死亡病例中,43%发生在最初的24小时内,很少因为器官功能障碍使我们确定脑功能丧失的不可逆性,而是源于荒谬的复苏中断问题。

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