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[MEDSCAPE]:你是否熟悉热射病的诊治要点?(3/6)
2017年09月06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2. 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?

D. A recent viral infection increases the likelihood of heat-related illness 近期病毒感染可增加热相关疾病的风险

正确答案:D. A recent viral infection increases the likelihood of heat-related illness 近期病毒感染可增加热相关疾病的风险

Risk factors that increase the likelihood of heat-related illnesses include a preceding viral infection, dehydration, fatigue, obesity, lack of sleep, poor physical fitness, and lack of acclimatization.

增加热相关疾病风险的危险因素包括病毒感染,脱水,乏力,肥胖,缺乏睡眠,身体健康状况不佳及水土不服。

Heat stroke is defined as hyperthermia exceeding 106°F associated with an altered sensorium. However, when a patient is allowed to cool down before measurement of the temperature (as may occur during transportation in a cool ambulance or evaluation in an emergency department), the measured temperature may be lower than 106°F, making the temperature criterion relative. Anhidrosis, or lack of sweating, has been cited as a feature of heat stroke, but some patients with heat stroke present with profuse sweating. Because of variable presentations, a high index of suspicion is needed to avoid delays in diagnosis and treatment.

热射病定义为体温超过106°F伴意识改变。然而,测定体温前若采取了降温措施(在救护车转运过程中,或在急诊科评估期间均可出现),测量的体温可能低于106°F,因而体温标准是相对的。无汗是热射病的特征性表现,但部分热射病患者可出现大汗。由于临床表现各异,临床医生应当对热射病保持高度警惕,以避免延误诊断与治疗。

Although lack of acclimatization is a risk factor for heat stroke, EHS also can occur in acclimatized individuals who are subjected to moderately intense exercise. EHS also may occur because of increased motor activity due to drug use, such as cocaine and amphetamines, and as a complication of status epilepticus.

尽管水土不服是热射病的危险因素之一,但已经适应环境的患者经过中等强度锻炼后也可发生EHS。吸毒(如可卡因和安非他命)引起活动增多,以及癫痫持续状态均可并发EHS。

Patients with NEHS may initially exhibit a hyperdynamic circulatory state, but in severe cases, hypodynamic states may be noted.

NEHS患者最初可表现为高动力状态,但严重病例可出现低动力状态。

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

Which of the following is accurate about the physical examination of patients with heat stroke? 有关热射病患者体格检查的以下说法哪个是准确的?

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