重症中暑患者并发多脏器功能障碍综合症的治疗分析

发布时间：2018-01-26 01:11

本文关键词： 重症中暑 MODS 凝血异常低分子肝素热休克蛋白 MOF　出处：《泰山医学院》2014年硕士论文　论文类型：学位论文

【摘要】：目的:中暑指的是身体在高温或热辐射的环境下,机体出现调节和代谢障碍,并引发机体的水、电解质代谢紊乱及其他器官功能损害的症状。中暑的主要表现是患者的体温调节中枢功能障碍,并伴有汗腺功能衰竭等并发症状。从临床表现的严重程度来说,中暑可以分为先兆中暑、轻症中暑和重症中暑。其中重症中暑包括了热痉挛、热衰竭和热射病。中暑中最为严重的类型就是热射病。重症中暑后往往伴随多器官功能的损害,治疗不及时极有可能导致不可逆的脏器损害,遗留后遗症,甚至患者死亡,为了更好的总结经验,找出规律,指导治疗,现探讨重症中暑后人体各脏器出现病理损害的先后顺序及其应对措施。材料与方法:回顾性分析泰山医学院附属医院在2009年7月至2013年7月之间收治的12例重症中暑并发MODS的患者的病情演变及治疗经过的情况,对12例重症中暑患者行进常规检查,发现其中凝血异常1-3日发生率为100%、100%、100%;12例重症中暑患者中心肌损伤1-3日发生率分别为:67%、83%、100%;脑损害影像阳性率为0、0、25%;急性肺损伤发生率分别为0、8%、17%;其中肾功损害1-3日发生率分别为:42%、58%、67%;12例重症中暑患者中消化系统肝损害1-3日发生率分别为:58%、83%、100%。结论:重症中暑患者的各项辅助检查指标中,凝血功能紊乱发生最早、最广泛,在患者病情预后中起关键作用。
[Abstract]:Objective: heatstroke refers to the body in the high temperature or thermal radiation environment, the body appears regulatory and metabolic disorders, and cause the body of water. Symptoms of electrolyte metabolism disorder and other organ dysfunction. The main manifestation of heatstroke is the central dysfunction of body temperature regulation and complications such as sweat gland failure. Heatstroke can be divided into premonitory heatstroke, mild heatstroke and severe heatstroke. Severe heatstroke includes heat spasms. Heat exhaustion and heat emission disease. The most serious type of heatstroke is heat radiation disease. Severe heat stroke often accompanied by the damage of multi-organ function, treatment is not timely may lead to irreversible organ damage, legacy. Even the death of patients, in order to better sum up experience, find out the rules, guide treatment. This paper discusses the sequence and countermeasures of pathological damage in organs after severe heatstroke. Materials and methods:. 12 patients with severe heat stroke complicated with MODS from July 2009 to July 2013 in affiliated Hospital of Taishan Medical College were analyzed retrospectively. Twelve patients with severe heatstroke were examined by routine examination and the results showed that the incidence of coagulation abnormality in 1-3 days was 100% and 100%. In 12 patients with severe heatstroke, the incidence of myocardial injury in 1-3 days was respectively 1: 67 and 833100; The positive rate of brain damage image was 0% and 25%; The incidence of acute lung injury was 0, 8 and 17, respectively. The incidence of renal function damage in 1-3 days were: 1: 42 and 58 / 67 respectively. In 12 patients with severe heatstroke, the incidence of hepatic injury in digestive system for 1-3 days was 1: 58 and 83 / 100, respectively. Conclusion: among all the auxiliary examination indexes of severe heat stroke patients. Coagulation disorder is the earliest and most widespread, and plays a key role in the prognosis of patients.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R594.12

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