中暑治疗流程

2018-07-12 佚名 重症医学

中暑是指在高温(>42℃)、高湿(>60%)和无风的环境下长期或强体力劳动时,患者所出现的以体温调节中枢和汗腺功能障碍,水和电解质丧失过多为特征的疾病。根据发病机制和临床表现,中暑可分为热痉挛、热衰竭和热射病。

中暑是指在高温(>42℃)、高湿(>60%)和无风的环境下长期或强体力劳动时,患者所出现的以体温调节中枢和汗腺功能障碍,水和电解质丧失过多为特征的疾病。根据发病机制和临床表现,中暑可分为热痉挛、热衰竭和热射病。

中暑的诊治流程见下图。

注意事项

1.无任何单独一项诊断试验可以肯定地明确诊断或排除热射病。此外,热射病患者的实验室检查结果异常可能与其他疾病导致的高热相重叠。例如,热射病患者通常符合全身炎症反应综合征(Systemic inflammatory response syndrome, SIRS)的诊断标准。不太可能在患者病程早期就区分出这两种疾病。在不清楚过热病因但仍有热射病可能性的情况下,谨慎的做法是在寻求除热射病之外的诊断时便开始采取降温措施。

2.因为蒸发降温具有非侵入性、易于操作并且不对患者其他方面的治疗产生干扰的优点,所以,该法最常用于治疗经典型热射病。在进行蒸发降温时,应脱去患者衣物,将微温水喷洒在患者身上,同时使用风扇,使空气吹过湿润皮肤。将患者浸入冰水中也是一种有效的、非侵入性的快速降温方法。尽管流程图中有冰水浴方法,但该方法会对生命体征等监测和静脉通路造成影响,并且可能对老年患者有害,故应避免冰水浴。

3.退热剂(如对乙酰氨基酚或阿司匹林)在热射病的治疗中并无作用,因为该疾病的基础机制并不涉及下丘脑调定点的改变,并且这些药物可能加重并发症(如肝脏损伤或DIC)。在最初尚不清楚患者过热病因并仍存在感染可能的情况下,在给予降温处理的同时,在取得适当的培养标本后经验性给予初始剂量的抗生素是谨慎的做法。

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    2018-07-12 flysky120

    收藏了谢谢非常感谢

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=331085, encodeId=60143310858b, content=收藏了谢谢非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu Jul 12 13:52:58 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331082, encodeId=dd3f3310820a, content=有了这.不用跑医院.不然又得说我是乳房炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jul 12 13:28:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331076, encodeId=7cc63310e66a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jul 12 12:52:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331065, encodeId=4b4a3310659d, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Jul 12 12:48:33 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331058, encodeId=f56b33105880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jul 12 12:17:26 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-12 sillywu

    有了这.不用跑医院.不然又得说我是乳房炎了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=331085, encodeId=60143310858b, content=收藏了谢谢非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu Jul 12 13:52:58 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331082, encodeId=dd3f3310820a, content=有了这.不用跑医院.不然又得说我是乳房炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jul 12 13:28:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331076, encodeId=7cc63310e66a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jul 12 12:52:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331065, encodeId=4b4a3310659d, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Jul 12 12:48:33 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331058, encodeId=f56b33105880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jul 12 12:17:26 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-12 phoebeyan520

    学习了.谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=331085, encodeId=60143310858b, content=收藏了谢谢非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu Jul 12 13:52:58 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331082, encodeId=dd3f3310820a, content=有了这.不用跑医院.不然又得说我是乳房炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jul 12 13:28:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331076, encodeId=7cc63310e66a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jul 12 12:52:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331065, encodeId=4b4a3310659d, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Jul 12 12:48:33 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331058, encodeId=f56b33105880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jul 12 12:17:26 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-12 虈亣靌

    很好的学习机会

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=331085, encodeId=60143310858b, content=收藏了谢谢非常感谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu Jul 12 13:52:58 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331082, encodeId=dd3f3310820a, content=有了这.不用跑医院.不然又得说我是乳房炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jul 12 13:28:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331076, encodeId=7cc63310e66a, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Jul 12 12:52:14 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331065, encodeId=4b4a3310659d, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Jul 12 12:48:33 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331058, encodeId=f56b33105880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jul 12 12:17:26 CST 2018, time=2018-07-12, status=1, ipAttribution=)]
    2018-07-12 131****1460

    学习了受益匪浅

    0