98心脏性猝死SCD的一级和二级预防讲稿.pptxVIP

心脏性猝死(SCD)的一级和二级预防 XX省心血管病研究所 ; 各种心脏原因 急：1小时内死亡 不可预料的 自然的病理生理过程 非人为或外伤因素;心脏猝死是最常见、最凶险的死因; ?????????????????????????????????????????????????????????????????????????????????????????? FIGURE 26–16. Influence of response time on survival from out-of-hospital cardiac arrest. A, The time from onset of cardiac arrest to initial defibrillation attempt is related to 1-month survival, based on data from the Swedish Cardiac Arrest Registry.336 The cumulative survival rate was 5 percent, and the survival rate for victims whose initial rhythm was ventricular tachycardia (VT) or ventricular fibrillation (VF) was 9.5 percent. The median response time was nearly 13 minutes. Thirty-day survival ranged from a maximum of 48 percent with responses of less than 2 minutes to less than 5 percent for response time greater than 15 minutes. B, The potential for faster response systems, based on the Amsterdam Resuscitation Study, is demonstrated, comparing response times of police vehicles with those of conventional emergency medical systems. At the 50th percentile of response times, polices vehicles provided a nearly 5 minute improvement in arrival time (approximately 6 minutes).337 Preliminary data suggest that improved response times of this type translate to improved survival.338 W.B. Saunders Company items and derived items copyright ? 2001 by W.B Saunders Company. ;40-45万 (Circulation 2001;104:2158-2163) 5-15%能到医院, 1-20%幸存 50%出院前SCD发作;先 兆;流行病学;心脏猝死(SCD)的发病率;Relative Risk Factors; ??????????????????????????????????????????????????????????????????? FIGURE 26–4. Risk of sudden death by decile of multivariant risk: 26-year follow-up, the Framingham Study. ECG = electrocardiographic; I–V = intraventricular; LVH = left ventricular hypertrophy; non-spec abn = nonspecific abnormality. (From Kannel WB, Shatzkin A: Sudden death: Lessons from subsets in population studies. Reprinted by permission of the American College of