现在的位置: 首页临床话题, 模拟诊室>正文
[MEDSCAPE]:你是否熟悉热射病的诊治要点?(6/6)
2017年09月18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5. Which of the following is accurate about the treatment of heat stroke?有关热射病的治疗,以下说法哪个是准确的?

A. Patients with EHS should be admitted to the hospital for 24 hours, but patients with NEHS typically do not require hospitalization EHS患者应住院24小时,但NEHS患者通常无需住院治疗

B. Cooling of athletes with EHS should be delayed until further evaluation and treatment in an emergency department 对于EHS的运动员,应当延迟降温,直至在急诊科进行进一步评估与治疗

C. Rapidly lowering the core temperature to approximately 102°F is the primary goal of treatment in patients with EHS 使核心体温迅速降低到102°F左右,是EHS患者的首要治疗目标

D. Aggressive fluid resuscitation is recommended in patients with NEHS, as cooling alone is typically not enough to improve hypotension and cardiac function 对于NEHS患者,推荐积极的液体复苏,因为单纯降温不足以改善低血压和心脏功能

正确答案:C. Rapidly lowering the core temperature to approximately 102°F is the primary goal of treatment in patients with EHS 使核心体温迅速降低到102°F左右,是EHS患者的首要治疗目标

Controversy still exists over what therapeutic modality is most effective in the treatment of heat stroke. However, the basic premise of rapidly lowering the core temperature to about 102°F, to avoid overshooting and rebound hyperthermia, remains the primary goal.

有关热射病最有效的治疗措施仍存在争议。然而,治疗的主要目的是迅速将核心体温降低到102°F左右,并避免体温超射及反跳。

Patients diagnosed with EHS or NEHS should be admitted to the hospital for at least 48 hours to monitor for complications.

诊断为EHS或NEHS的患者应当住院治疗至少48小时,以监测并发症。

The American College of Sports Medicine recommends that cooling be initiated at the scene, before transporting the patient to an emergency department for further evaluation and treatment. Despite extensive education and training, delays are still reported, owing to trepidation by athletic trainers to accurately diagnose and rapidly initiate treatment for EHS.

美国运动医学学院推荐在将转运至急诊科进行进一步评估与治疗前,应当在现场开始降温。尽管进行了普遍的宣教与培训,但由于接受培训的运动员对于准确诊断EHS并迅速开始治疗存在疑虑,因此延误仍很常见。

Although patients with heat stroke invariably are volume-depleted, cooling alone may improve hypotension and cardiac function by allowing blood to redistribute centrally. Aggressive fluid resuscitation is generally not recommended because it may lead to pulmonary edema.

尽管热射病患者均存在容量缺乏,但降温措施本身即可通过促进血液在中心分布,从而改善低血压和心脏功能。由于可以导致肺水肿,因此通常不推荐积极的液体复苏。

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

给我留言

您必须 [ 登录 ] 才能发表留言!

×
腾讯微博