目的:分析脑出血死亡时间及死因,找出脑出血不同死亡时间的主要死因,为制定脑出血不同时间的相应救治措施提供依据。方法:回顾性总结分析２１１ 例脑出血死亡病例的死亡时间、主要死因,找出不同死亡时间对应的主要死因。 结果: (１)死亡时间:≤３ 天 ９１ 例、４~７天 ５２ 例、８~１４ 天 ４２ 例、１５~２１ 天１８ 例、２２~２８ 天 ７ 例、≥ ２９ 天 １ 例。(２)死亡原因:１６９ 例死于脑疝及中枢性呼吸、循环衰竭;20例死于肺部感染;１０ 例死于消化道出血;4 例死于多器官功能衰竭;４ 例死于心脏病变(如心脏猝死、心肌梗塞、心功能衰竭);其它４例(痰窒息、肾功能衰竭、肝功能衰竭)。(３)不同死亡时间主要死亡原因:≤３ 天 ９０ 例死于脑疝及中枢性呼吸、循环衰竭,仅 １ 例死于消化道出血;４～７ 天４７ 例死于脑疝及中枢性呼吸、循环衰竭,３ 例死于肺部感染,死于心脏病变及其它各１例;８~１４ 天 ２９ 例死于脑疝及中枢性呼吸、循环衰竭,８ 例死于肺部感染,２ 例死于消化道出血,死于心脏病变、多器官功能衰竭、其它各 １ 例;１５~２１ 天 ７ 例死于肺部感染,５ 例死于消化道出血,３ 例死于脑疝及中枢性呼吸、循环衰竭,死于心脏病变、多器官功能衰竭、其它各１例;２２～２８天死于消化道出血、肺部感染各２ 例,死于心脏病变、多器官功能衰竭、其它各１ 例,已无死于脑疝及中枢性呼吸、循环衰竭者;２９ 天后死于多器官功能衰竭１ 例。结论: 脑出血死亡时间不同,其主要死亡原因不同。临床应该针对不同死亡时间的主要死因制定相应救治方案,以降低死亡率。
At the end of 2022, the National Medical Products Administration (NMPA), in conjunction with the National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College raised for the first time the important issue of clinical research globally: whether the source of the death time of clinical trials based on the simple follow-up records is credible, and proposed a consensus document on the source of the death time of clinical trials. The results were published in The Lancet Regional Health-Western Pacific, which attracted wide attention and recognition from the international industry. This is the first time that the China consensus on quality standards for clinical research has been ahead of the U.S. Food and Drug Administration and other international colleagues. The NMPA has been leading China in promoting the scientific development of clinical research, so as to constantly establish and improve the scientific regulatory system and ecological system, and promote China's full integration into the global pharmaceutical research and development system. China clinical research institutions and the whole industry are also gradually from standardized development to scientific development, high-quality development process. In this study, we summarized the scientific and subject-oriented development of China clinical research industry in recent years, and continuously strengthened the international competitiveness of China pharmaceutical industry. It is suggested that scientific thinking model should be used to deal with the normative problems in clinical research and promote the development of medical model to scientific model.