最后审阅: 19 九月 2021
最后更新: 07 一月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 暴露于环境酷热或剧烈运动史
  • 中枢神经系统功能障碍
  • 体温过高(>40°C)
  • 无汗症
  • 危险因素

其他诊断因素

  • 极度口渴(热射病或热衰竭)
  • 虚弱(热射病或热衰竭
  • 焦虑(热射病或热衰竭
  • 头晕(热射病或热衰竭
  • 晕厥(热射病或热衰竭
  • 头痛(热射病或热衰竭
  • 恶心/呕吐(热射病或热衰竭
  • 窦性心动过速
  • 呼吸急促
  • 黄疸
  • 肌肉压痛
  • 低血压
  • 瘀伤和皮肤出血

危险因素

  • 老年
  • 认知受损
  • 患者无法照顾自己
  • 药物治疗
  • 缺乏对高温环境的适应能力
  • 已患有脱水
  • 肥胖
  • 机体状况较差
  • 环境因素
  • 在高温高湿条件下剧烈运动的年轻人、活跃人群

诊断性检查

首要检查

  • 直肠温度
  • 全血细胞计数 (FBC
  • 肝功能检测
  • 肾功能检查
  • 葡萄糖
  • 电解质
  • 动脉血气分析
  • 肌酸激酶
  • 凝血功能检查
  • 尿液分析
  • 心电图(ECG

治疗流程

撰稿人

专家顾问

Alexander Alexiou, MB, BS, BSc, DCH, FRCEM, Dip IMC RCSEd

Flight Doctor

Greater Sydney Area Helicopter Emergency Medical Service

Sydney

New South Wales

Australia

利益声明

AA declares that he has no competing interests.

鸣谢

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work is retained in parts of the content:

James L. Glazer, MD, FACSM, CAQSM

Assistant Professor

Tufts University School of Medicine

Boston

MA

同行评议者

Helen Small, FRCEM, MSc Sports and Exercise Medicine

Consultant in Emergency Medicine

Barnet Hospital

Royal Free London

London

UK

利益声明

HS declares that she has no competing interests.

编辑

Helena Delgado-Cohen,

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Rachel Wheeler,

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Annabel Sidwell,

Comorbidities Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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