第六章 猝死课件.pptVIP

第七章 猝死sudden death 一、猝死的概念 猝死（sudden death）是指一个貌视健康的人，由于潜在的疾病或机能障碍，发生突然的、出人意外的非暴力死亡。即急速、意外的自然性死亡（sudden unexpected natural death）。 指貌似健康者，因内在疾病发作或恶化而发生的急骤死亡。 Sudden death Sudden death is a death which is not known to have been caused by any trauma, poisoning or violent asphyxia, and where death occurs all on a sudden or within 24 hours of the onset of the terminal symptoms. Thus , by definition sudden deaths are mostly natural deaths where deaths occur immediately or within 24 hours of the onset of the terminal symptoms, which may be totally different from the symptoms, which the patients were having so long. The definition does not essentially exclude or rule out deaths due to means other than natural diseases, but no unnatural causes should be apparent. If the cause is diagnosed or known to be unnatural one, it can’t be termed as sudden death. 二、猝死的特点： 1、急速性死亡：WHO: 24h；1h～2h；即时死（instantaneous death)。 2、意外性死亡:突然，出人意料，令人怀疑，可疑暴力死。 3、自然性死亡: natural death，non-violent death 三、猝死的原因 各个系统疾病均可引起猝死，其中在成人以心血管系统疾病占首位,其次为中枢神经系统疾病和呼吸系统疾病，消化系统、泌尿系统、生殖系统和内分泌系统等疾病相对较少。 不同年龄组引起猝死的常见疾病也有差异，如婴幼儿以呼吸系统疾病最为常见;而青壮年以后则以心血管系统疾病为主。 The incidents of sudden death is about 10% of all cases of death. Of these again most of the deaths are due to cardiovascular or circulatory causes. Next in frequency are due to respiratory causes. Of all cases of sudden deaths about 45% are due to pathology in the cardiovascular system, about 20% due to pathology of the respiratory system, about 15% due to central nervous system,about 6% due to alimentary causes, about 4% due to genito-urinary causes and rest 10% are due to miscellaneous causes. Among the cardiac causes, the most frequent are- 1. Coronary artery atheroma，Coronary thrombosis and myocardial infarction.冠状动脉粥样硬化、栓塞和心肌梗死 2. Stenosis and insufficiency of valves.瓣膜狭窄和关闭不全 3. Congenital heart diseases. 先天性心脏病 4. Acute and constrictive pericarditis. 急性缩窄性心包炎 5. Degenerative conditions of heart and heart vasculatures 心肌和心脏血管的退