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[MEDSCAPE]:你是否熟悉热射病的诊治要点?(2/6)
2017年09月02日 临床话题, 模拟诊室 暂无评论

Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke?

Richard H. Sinert, DO

August 02, 2017

问题1. Which of the following is an indicator of poor prognosis during acute episodes of heat stroke?热射病急性期的以下哪种表现提示预后不良?

A. 

B. Aminotransferase levels > 800 IU/L during the first 12 hours 最初12小时转氨酶> 800 IU/L

C. Initial temperature measurement > 104°F, a temperature > 106°F at any point, or a temperature persisting above 100°F despite cooling measures 初始体温> 104°F,任何时间体温> 106°F,或降温后持续> 100°F

D. Hypertension 高血压

正确答案:A 

Indicators of poor prognosis during acute episodes include the following:

急性期提示不良预后的表现包括:

  • Initial temperature measurement higher than 106°F or a temperature higher than 108°F or a temperature persisting above 102°F despite aggressive cooling measures 初始体温> 106°F,或任何时间体温> 108°F,或在积极降温措施下体温持续> 102°F
  • Coma duration longer than 2 hours 昏迷持续时间超过2小时
  • Severe pulmonary edema 严重肺水肿
  • Delayed or prolonged hypotension 迟发或长时间低血压
  • Lactic acidosis in patients with classic heat stroke 典型热射病患者出现乳酸酸中毒
  • Acute kidney injury and hyperkalemia 急性肾损伤及高钾血症
  • Aminotransferase levels greater > 1000 IU/L during the first 24 hours 最初24小时转氨酶水平> 1000 IU/L

Morbidity and mortality from heat stroke are related to the duration of the temperature elevation. When therapy is delayed, the mortality rate may be as high as 80%; however, with early diagnosis and immediate cooling, the mortality rate can be reduced to 10%. Mortality is highest among elderly persons, patients with preexisting disease, those confined to bed, and those who are socially isolated.

热射病的罹患率及病死率与高热持续时间相关。当治疗延误时,病死率可高达80%;然而,如果做到早期诊断和及时降温,病死率可降低到10%。老年人、有基础疾病患者,卧床患者及与社会隔绝的患者病死率最高。

For more on the prognosis of heat stroke, read here.

Which of the following is accurate about the presentation of heat stroke? 以下哪种说法准确描述了热射病的临床表现?

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