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山形市において突然心・呼吸停止をきたして搬送された症例をおもな検討対象とし,突然死の実態を把握することを試みた。昭和59年から3年間の症例数は303例(男女比2.1対1)で発症率は年齢とともに増加し,冬および夕方・早朝に高かった。昭和59年からの4年間の当院搬送194例の原因疾患は,心疾患が90例(46.4%)と最多で,頭蓋内出血が36例(18.6%)と続いた。心疾患についてみると,虚血性心疾患が65.6%と最多であった。救命率は心疾患全体で20.0%で,急性心筋梗塞例が18.8%であるのに比し血管攣縮性狭心症例は71.4%と高かった。また心室細動例の救命率が40.0%と高く,心室停止・高度の徐脈の症例では低い救命率であった(11.8 & 15.4%)。心・呼吸停止より心肺蘇生術開始までの時間は,救命例で死亡例に比し有意に短かった(1.5±2.3 vs 8.0±8.4分,p<0.001)が,病院到着までの時間は有意差がなかった。心疾患の治療歴が47.8%に,また前兆が33.3%の症例に認められた。
We investigated 303 (men: women=2: 1) cases who suffered sudden heart arrest in Yamagata city since 1984 to 1987. The incidence rate was 41.0/ 100,000/year, and increased markedly with increas-ing age. There was a tendency for sudden death to occur in the winter season, evening and early morning. Two major causes were cardiac disease (especially ischemic heart disease) (46.4%) and in-tracranial hemorrhages (18.6%). 20% of all the heart-arrest cases were able to be saved, but, de-pending on the kind of heart disease the survival rate varied greatly (18.8% in acute myocardial infarction and 71.4% in vasospastic angina), (40.0% in ventricullar fibrillation and 13.3% in the brady-cardic arrythmias). Survival rate was also effected by the time interval from the onset till the beginning of cardio-pulmonary resuscitation. About one half of the cases had histories of cardiac disease. Pre-monitory symptoms were observed in at least one third of the cases.
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