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        昏迷硕士学位论文 急诊内科昏迷患者110例诊治

        版权:原创标记本站原创 星级:★★★★4.0主题:昏迷不醒范文 级别:标准毕业论文 范畴:专科学年论文 论文范文编号:biyelunwendq0197933 期刊发表:国家级期刊 全文字数:3000字 投稿作者:vddmbj 审稿编辑:闻名学术家 阅读次数:46104

        本论文可用于昏迷论文范文写作参考研究.

        急诊内科昏迷患者110例诊治分析【摘要】目的探讨急诊内科昏迷患者的病因、诊断及抢救措施。策略对我院110例急诊内科昏迷病人进行回顾性的分析,将这80例昏迷病人的诊断措施与治疗措施进行研究。结果在分析的110例昏迷患者中成功的有96例。死亡的有8例,转院的有6例,成功率为87.27%,病死率为7.27%,转院率为5.45%。结论昏迷患者病情危重,死亡率高,结合病史,及时辅检,明确病因,对症治疗。

        昏迷不醒论文 昏迷不醒

        超敏C反应蛋白增高在脑出血昏迷患者中的检验意义

        脑出血昏迷患者的急诊护理观察

        小学科学迷思概念转换策略

        口腔科拔牙患者的护理要点应用价值评估

        【关键词】急诊昏迷内科

        1005-0019(2015)01-0509-01

        昏迷是急诊科常见的急危重症,往往因为病因不详,导致医护人员对患者进行诊断时不能及时确诊,从而使得患者病情加重。常见病因有急性脑血管病、急性中毒、外伤、代谢性疾病等。如何对患者进行及时的确诊及正确的治疗是对昏迷患者救治的关键因素。笔者总结110例内科昏迷患者进行临床分析,发现针对病因采取抢救措施的患者抢救成功率较高,现总结如下。

        1、资料与策略

        1.1一般资料根据Glasgow评分量表,Glasgow评分3~8分确诊为昏迷患者,本组110例,年龄12~90岁,男62例,女48例,两组患者在年龄、病因、危重程度等方面差异无统计学作用。

        1.2急诊抢救措施

        首先抓住危及患者生命的关键理由,同时进行病史询问和体格检查,进行必要的辅助检查,如血生化、心电图、超声、x线等,评估病情,病情许可可搬动行CT等影像学检查以及洗胃、透析等治疗。对心跳呼吸停止的患者,应立即开通气道,行基本生命支持及进一步行高级生命支持,生命体征平稳可转运至重症医学科监护治疗,或转运至相关科室病房进一步治疗。

        2、结果

        我院急诊昏迷患者的病因常见以下3种情况:①急性中毒占47.9%,包括急性酒精中毒(7.9%)、地西泮中毒(11.8%)、急性有机磷农药中毒(6.3%)、煤气中毒(18.9%),年龄以22~39岁的青壮年为主,该年龄段病例数占总病例的87.0%以上;②脑血管意外占26%,包括脑出血、脑梗死。二者发病率基本相同年龄以60~80岁老年患者为主;③严重创伤占13.4%,包括脑外伤和多发伤,年龄以25~40岁的中青年为主;④其他因素:代谢性因素占8.6%,肺性脑病、肝性脑病各占1.6%、2.4%。⑤其他创伤:如电击伤、溺水等占4.3%。

        临床结果:本组110例急诊内科昏迷患者经抢救治疗后,抢救成功者96例,死亡的有8例,转院的有6例,成功率为87.27%,病死率为7.27%,转院率为5.45%。

        3、讨论

        昏迷是高级神经活动受到极度抑制后,陷入无意识状态,不能被唤醒,对外界刺激或内部需求没有任何心理学上可理解的反应,患者表现为睡眠状态,只能对肢体屈曲或伸展以及疼痛刺激引起偶尔反应,对其余任何外界刺激没有正常的反应?;杳允怯赡怨δ芩ソ咭鸬?,致死理由与血压过高或过低、缺氧、脑干受压等因素有关。有上述不良因素者大多预后不良,如能早期去除危险因素,防止发生脑部或全身的缺血缺氧、颅内高压、血压过高或过低、呼吸道阻塞等继发性伤害,尽可能早期治疗,可使死亡率降低,达到抢救患者生命的目的。对昏迷患者的抢救,除根据其临床表现和症状采取一般及对症紧急抢救措施外,还应该详细查体及进行实验室和影像学检查,明确病因,根据病因给予针对性和系统专业的治疗,以去除病因,这是患者治愈疾病和康复的保证。

        肝昏迷症状

        医患关系本科毕业论文模板医患关系专科论文格式医患关系本科论文范文医患关系本科论文格式医患关系本科毕业论文开题报告医患关系专科论文范文

        急诊内科昏迷患者110例诊治自考毕业论文开题报告相关参考属性
        有关论文范文主题研究: 关于昏迷论文范文检索 大学生适用: 3000字在职论文
        相关参考文献下载数量: 70 写作解决问题: 写作参考
        毕业论文开题报告: 论文任务书、论文选题 职称论文适用: 职称评定、职称评初级
        所属大学生专业类别: 昏迷不醒方面 论文题目推荐度: 经典昏迷题目

        3.1一般及对症紧急抢救措施:保持呼吸道通畅,头偏向一侧,及时清除口腔及呼吸道分泌物;给予高流量吸氧,必要时气管插管或者气管切开辅助呼吸;迅速建立两条以上静脉通道,抽取静脉血做必要的生化检查和毒物分析,给予心电监护监测生命体征变化,观察尿量。对症抢救措施:呕吐、偏瘫等颅内高压症者,应用脱水利尿剂,减轻脑水肿;口服中毒者,立即给予催吐、洗胃处理,应用解毒剂;抽搐频繁者,应用解痉药,给予加固和床档防护措施,保障患者安全;休克者给予补充血容量,纠正休克。

        3.2针对病因抢救:给予相关实验室监测和影像学检查,针对昏迷的病因采取系统专业的抢救措施。颅内出血者,转脑外科急诊手术处理;心源性昏迷患者急查心电图,根据心电图情况给予改善心功能和心脏供血、纠正心律失常治疗;Ⅲ度房室传导阻滞者,应安装临时起搏器,心律失常难以纠正者,在给予药物纠正心律的同时,给予同步直流电复律治疗;酮症酸中毒者,以小剂量胰岛素静脉缓慢滴注,随时监测血糖变化,同时纠正脱水;低血糖昏迷休克者,应先静脉注射50%葡萄糖溶液,血糖恢复后进行糖尿病专科治疗;肝昏迷患者,立即给予弱醋酸保留灌肠,同时静脉给予降低血氨药物;肺性脑病给予抗感染、纠正酸碱失衡治疗等。

        无论何种理由引起的昏迷,常提示后果严重。临床医生必须加强对昏迷患者的认识,在急诊工作中。对昏迷患者处理必须急中有急,抓住疾病的本质,处理关键理由。强调急诊医生在接诊昏迷患者时,既要考虑临床常见病,也要考虑少见病。

        总之,迅速抢救,及时有效的处理,可以明显降低病死率,提高抢救的成功率。

        参考资料:

        [1]急诊内科昏迷患者的原因治疗

        [2]120例急诊内科昏迷患者的病因治疗方法

        名家点评

        怎样撰写昏迷本科论文?这篇肝昏迷症状论文范文为免费优秀学术论文范文,可用于相关写作参考,可作为不知如何写患者和病因和急诊方面的大学硕士和本科毕业论文以及关于论文开题和相关职称论文作为参考文献资料.

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