heat stroke
Introduction
Introduction It refers to the imbalance of human body temperature regulation caused by high temperature, and the body's heat is excessively accumulated, which causes damage to nerve organs. Heatstroke is a severe heatstroke in the classification of heatstroke. It is a fatal disease with a high mortality rate. The disease usually occurs in the summer with high temperature accompanied by high-humidity weather. In case of high temperature, once there is sweating and sorrow, pay attention to cooling. If coma occurs at high temperature, the comatose should be immediately transferred to a cool and ventilated place. The cold water should be wiped repeatedly, and then the body temperature should be continuously monitored. If the temperature continues, it should be sent to the hospital for treatment. Do not be normal heatstroke. And small vision, delay treatment time.
Cause
Cause
Inadequate adaptation to high temperature environments is the main cause of the disease. In an environment with elevated atmospheric temperature (>32 °C), high humidity (>60%) and no wind, long-term work or strong physical labor, and no adequate heatstroke prevention measures, the lack of adaptation to high-heat environment is prone to occur. Heat sickness. Probable factors include:
1 The ambient temperature is too high The human body receives heat from the external environment.
2 Increased body heat production such as heavy physical labor, fever, hyperthyroidism and the application of certain drugs (amphetamine).
3 heat dissipation barriers such as high humidity, obesity or poor ventilation.
4 sweat gland dysfunction is seen in patients with systemic sclerosis, extensive skin burns after scar formation or congenital sweat gland deficiency.
Examine
an examination
Related inspection
Plasma osmotic pressure (POP) body temperature measurement ambulatory blood pressure monitoring (ABPM)
High potassium, high calcium, increased white blood cell count, decreased platelet count, increased creatinine, urea nitrogen, alanine transferase (GPT), lactate dehydrogenase (LDH), creatine kinase (CK), electrocardiogram arrhythmia And myocardial damage.
Diagnosis
Differential diagnosis
The following identification should be done when heat stroke occurs:
1. Geriatric pneumonia and heatstroke coexist with its clinical manifestations are diverse, and even lack of respiratory symptoms, such as cough, expectoration, etc., but also lack of typical pneumonia, signs: can be expressed as loss of appetite, discretion or mental disorders Some manifested as palpitations, chest tightness, tachycardia arrhythmia (atrial premature beats, ventricular premature beats), etc., fever, body temperature is more than 39 ° C, individual can be no fever, only sweating. Peripheral blood, white blood cells are normal or elevated, the classification is marked by neutral increase, easy to merge with water, electrolyte imbalance and acid-base balance disorders, shock, arrhythmia and respiratory failure, heart failure. Early respiratory sounds are weakened, a little wet sound can appear More often on the side of the local lung at the bottom. On the basis of chronic bronchitis, a variety of dry and wet sounds can appear in both lungs. The above lung signs can provide clues to pneumonia, and X-ray examination can confirm the diagnosis.
2. Cerebral hemorrhage and heat stroke coexist with the disease. The symptoms are sudden, vomiting, progressive speech and coma, snoring, urinary incontinence, and convulsions. Thalamic hemorrhage involving the hypothalamus and cerebral hemorrhage showed hyperthermia and coma, and CT can be clearly diagnosed.
3. The blood sugar level is lowered in the elderly, the incidence of diabetes is significantly higher in the age of 50 years old, the incidence rate is over 40% in the 50 years old, and the patient lacks the symptoms. The urine sugar is often negative. The heat stroke will make the condition worse. The incidence of recessive diabetes, the stress state of severe heat stroke can also increase blood sugar, but generally does not exceed 15 ~ 20mmol / L.
4. Diabetic ketoacidosis and non-ketotic hyperosmolar coma In the predisposing factors of the disease, infection is the first place, fever is one of the main symptoms, infection is more common in lung infection. Heatstroke is also one of the predisposing factors. It is often treated with coma, dehydration, and shock. Non-ketotic hyperosmolar coma is mostly seen in the elderly, and half of them have no history of diabetes. Laboratory tests can confirm the diagnosis.
