急诊内科2034例意识障碍患者的病因学回顾性分析  

The etiology of consciousness disorders in internal emergency department： retrospective analysis of 2034 cases

作　　者：刘利峰[1] 夏鹄[1] 刘先华[1] 吴航滨[1] 

机构地区：[1]中国人民解放军306医院急诊部,北京100101

出　　处：《中国急救复苏与灾害医学杂志》2011年第6期522-524,528,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的 探讨急诊内科意识障碍患者病因学构成及对临床预后的影响.方法 对急诊内科2034例意识障碍患者做病因学及相关资料的分析.结果 2034例意识障碍患者前6位病因依次为中枢神经系统疾病、中毒、休克、肺性脑病、心力衰竭及低血糖昏迷.中枢神经系统疾病导致的意识障碍占全部意识障碍患者的1/3,且发病时的血压明显高于其他组,以出血性脑血管病血压增高更明显,均有统计学意义（P〈0.01）.中毒病例中以酒精中毒比率最高,其次是镇静药物中毒,有机磷中毒的病死率高.中毒患者的平均年龄明显低于其他组（P〈0.01）;心力衰竭组65.55%为急性心肌梗死、心源性休克,病死率在各组中最高（P〈0.01）.结论 中枢神经系统疾病、中毒仍是急诊内科意识障碍的主要原因.意识障碍患者的早期诊断、及时的病因治疗是治疗的关键.Objective To explore consciousness disorder patients in the etiology formation and effects on clinical outcomes. Methods A retrospective analysis of 2034 cases of consciousness disorders was performed between January 2000 and September 2010 in The PLA 306th Hospital. Results The ordinal causes of consciousness disorders were central nervous system diseases, poisoning, shock, pulmonary encephalopathy heart failure and hypoglycemie coma. One third of consciousness disorder patients were suffered from central nervous system diseases, and had significantly higher blood pressure in comparison to the rest （P〈0.01）. The poisoned patients were mostly caused by alcoholism, followed by sedative medicine and organ phosphorus poisoning. The age of poisoned patients demonstrated significantly younger than the rest （P〈0.01）. 65.55 percent of patients with heart failure were caused by acute myocardial infarction and cardiac shock, which accounted for the highest mortality in all the groups （P〈0.01）. Conclusion Central nervous system diseases and poisoning are the leading causes of consciousness disorders in this study. It is essential to diagnose on early stage and provide timely treatment for consciousness disorders.

关 键 词：意识障碍 病因 急诊 

分 类 号：R741.041[医药卫生—神经病学与精神病学]