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近年来,由于设立于全国各地的急救中心的使用,为了复苏目的而移送入急救中心的到达时已死(DOA)患者较多,其复苏率低已成为重大的社会问题。在日本,重新对院前急救(prehospital care)问题进了研究,最近,一种专门从事院前急救的新的医疗职业即将出现。在欧美,猝死的原因多是由于以心肌梗塞为首的缺血性心脏疾患所引起。但由于电除颤技术用于急救和引入辅助医务人员制度(parame-dics),院外心脏停搏的复苏率已见改善,目前正全力进行猝死的急救工作。而在日本,有人指出,尸检证实因脑血管病而致猝死者居多。本文仅就为复苏目的而被移送入东邦大学急救中心的 DOA 患者的有关问题进行探讨。
In recent years, due to the use of first aid centers located throughout the country, more patients have been dead (DOA) at the time of resuscitation and transferred to emergency centers. The low rate of recovery has become a major social problem. In Japan, the issue of prehospital care has been revisited and more recently a new medical profession, specializing in pre-hospital care, is on the way. In Europe and the United States, the cause of sudden death is mostly due to myocardial infarction-led ischemic heart disease caused. However, because of the use of defibrillation for first aid and the introduction of parame-dics, the rate of recovery from out-of-hospital cardiac arrest has improved and the emergency work on sudden death is currently under way. In Japan, however, it was pointed out that autopsy confirmed the majority of sudden deaths due to cerebrovascular disease. This article discusses only the issues related to DOA patients who were transferred to the Tohoku University Emergency Center for resuscitation purposes.