现在位置是:首 页 >> 急诊学科 >> 危重病 >> 推荐文章
关键字:
推荐文章

    字体: | |

环境性高热:热衰竭还是热休克?
原作者: Jon Mark Hirshon,李辉译 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2015-02-09

Title: Environmental Hyperthermia: Is it heat exhaustion or heat stroke?
题目:环境性高热:热衰竭还是热休克?
Author 作者: Jon Mark Hirshon
翻译:李辉 校对:肖锋

Hyperthermia can be defined as a core body temperature > 38.5ºC.
高热可以被定义为中心温度> 38.5ºC。
In contrast to fever, the body’s temperature rises uncontrollably and the body is not able to dissipate the heat.
与(由疾病原因导致的)发烧不同,机体的温度不可控制地升高且不能散热。
There can be many causes of hyperthermia, including from environmental exposure.
多种因素可以导致高热,包括环境暴露。
There are two main environmental heat illnesses, heat exhaustion and heat stroke.
环境性热疾病主要包括两种,热衰竭和热休克。
Heat exhaustion:
热衰竭:
• Vague malaise, fatigue, headache
• 萎靡不振、疲劳、头痛
• Core temperature may be normal or elevated (below 40ºC)
• 中心体温可能正常或升高(低于40ºC)
• May have tachycardia, orthostatic hypotension, clinical dehydration
• 可能出现心动过速、体位性低血压、临床脱水表现
• Liver function tests (transaminases) may be normal or elevated
• 肝功能检查(转氨酶)可能正常或升高
• IMPORTANT- there is no altered mental status (i.e.: no coma or seizures)
• 重点- 没有意识改变(比如,没有昏迷或抽搐)
Heat stroke
· Usually tachycardia, orthostatic hypotension, clinical dehydration
· 常出现心动过速,体位性低血压,临床脱水表现
· May have hot, dry skin, but not always
· 皮肤热、干燥,但并不是总出现
· Liver function tests (transaminases) are markedly elevated
· 肝功能检查(转氨酶)显著升高
· May have rhabdomyolysis and renal failure
· 可能出现横纹肌溶解和肾衰竭
· IMPORTANT- Signs of altered mental status (i.e.: coma, seizure, delirium)
· 重点- 有精神状态改变表现(比如:昏迷,惊厥,精神错乱)
· Mortality may be up to 33%
· 死亡率可能高达33%
Bottom line:
概要:
• Heat stroke is a life threatening emergency.
• 热休克是威胁生命的急诊
• Early recognition and rapid appropriate therapy can save a life
• 早期发现和快速合理的治疗可以挽救生命
• The most effective cooling is evaporative cooling along with ice packs
• 最有效的降温方法是蒸发冷却联合冰袋物理降温
References 参考文献:
Management of the hyperthermic patient. Calvello EJ, Hu K, Khoujah D. Br J Hosp Med (Lond). 2011 Oct;72(10):571-5
Cooling Techniques for Hyperthermia by Schraga ED, Kates LW. Available at: http://emedicine.medscape.com/article/149546-overview

文章来源:《中华急诊医学杂志》编辑部