頁籤選單縮合
| 題 名 | Clinical Features of Fatal Asthma=氣喘死亡病例之臨床表現 |
|---|---|
| 作 者 | 陳炯睿; 李政宏; 朱遠志; 陳昌文; 張漢煜; 薛尊仁; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
| 卷 期 | 22:5 民95.05 |
| 頁 次 | 頁211-216 |
| 分類號 | 415.425 |
| 關鍵詞 | 致死性氣喘; 瀕臨死亡氣喘; 到院死亡; Fatal asthma; Near-fatal asthma; Dead on arrival; |
| 語 文 | 英文(English) |
| 中文摘要 | 為了要了解致死性氣喘發作之情形,我們回溯性分析從 1989 至 2003 年共 15 年間在本院因氣喘發作致死之病例。在此期間一共有 12 位主因為急性氣喘致死之病例,包括 8 位到院前死亡及 3 位患者在至急診處後一小時內死亡。此些 12 位患者根據此次致死性發作之臨床情形可區分為下列三種類型包括:第一型:3 小時內急性惡化至死亡有 4 個病例;第二型:2) 在幾天內逐步惡化至死亡有 2 個病例;第三型:3) 在幾天之不穩定期後突然急性惡化有六位病例。所有第一型及第二型之患者皆有以前頻臨死亡發作之病史,而六位第三型之患者僅有一位有以前瀕臨死亡發作之病史。在所有七位曾有以前瀕臨死亡發作病史之患者,五位之此次致死性氣喘發作之類型和以前之發作類型是一樣的。分析時也同時發現第三型之患者較年輕,一半 (3/6) 之患者年齡在 35 歲以下。我們總結發現幾乎所有之致死性氣喘皆是到院前死亡或至急診處一小時內死亡,且患者之急性氣喘發作致死之臨床表現和以前曾有之瀕臨死亡氣喘發作之模式非常相似。我們認為加強氣喘患者之衛教讓其了解急性發作之危險及儘早至急診處就醫,及急診處醫師足夠之治療與嚴謹監視病情之變化將可減少氣喘之致死性發作。 |
| 英文摘要 | To characterize the clinical features of fatal asthma, we retrospectively analyzed the clinical characteristics of patients who died of an acute asthma attack in our hospital during a 15-year period from 1989 to 2003. Twelve patients had fatal asthma during this period, including eight who were dead on arrival in the emergency room (ER) and three who died within 1 hour of admission to the ER. Patients were categorized into three groups according to the clinical presentations during the fatal attack: (1) rapid (< 3 hours) decompensation in four patients; (2) gradual development of respiratory failure over several days in two patients; and (3) acute deterioration after unstable asthma lasting several days in six patients. All patients in groups 1 and 2 had reported previous near-fatal attacks. The proportion of young patients was highest in group 3, with half of them (3/6) younger than 35 years of age. Only one patient in group 3 had had a previous near-fatal attack. Five of the seven patients, with previous near-fatal attacks, had a pattern of decompensation during their fatal attack that was similar to their previous attacks. In conclusion, nearly all patients with fatal asthma in this study died outside of the hospital or within 1 hour after admission to the ER. Patients had patterns of decompensation during the fatal attack that were similar to those of their previous attacks. Early detection of warning signs, early admission to the ER, adequate treatment, and extremely close observation of patients, especially within 1 hour after ER arrival, may prevent or decrease the incidence of fatal asthmatic attack. |
本系統中英文摘要資訊取自各篇刊載內容。