实用医药杂志
實用醫藥雜誌
실용의약잡지
Practical Journal of Medicine & Pharmacy
2015年
8期
695-697,701
,共4页
扈丽媛%焦海涛%丁怡%崔建斌
扈麗媛%焦海濤%丁怡%崔建斌
호려원%초해도%정이%최건빈
热射病%多器官功能障碍%凝血
熱射病%多器官功能障礙%凝血
열사병%다기관공능장애%응혈
Heatstroke%Multiple organ dysfunction%Coagulation
目的 对近8年来笔者所在医院收治的劳力性热射病(exertional heatstroke,EHS)和非劳力性热射病(classic heatstroke,CHS)患者临床资料进行比较分析、总结.方法 收集2006年-2013年入住解放军89医院的热射病患者23例,其中劳力性热射病患者13例,为EHS组;非劳力性热射病患者10例,为CHS组.另选取8例同时期的轻中度中暑患者为对照组. 记录分析纳入本研究患者的一般资料、实验室检查指标和临床治疗措施以及预后等,运用统计学方法比较分析三组患者的血常规、凝血四项检验指标的变化情况. 结果 CHS组患者较EHS组和对照组平均发病年龄偏高,基础疾病多,后遗症多;三组白细胞(white blood cell,WBC)计数均较正常值[(4~10) ×109/L]偏高,但组间比较无显著性差异(P>0.05);EHS 组患者入院时血小板(platelet,PLT)计数明显低于对照组(P<0.05),住院期间PLT峰值明显低于对照组和CHS组,P<0.05,差异有统计学意义;EHS组患者入院时凝血酶原时间 (thrombin time,PT)、 活化部分凝血酶原时间 (activated partial thromboplastin time,APTT) 及住院期间PT、APTT峰值与CHS组和对照组比较明显延长,P<0.05, 差异有统计学意义;CHS患者入院时PT、APTT及住院期间PT、APTT峰值与对照组比较无显著性差异(P>0.05).结论 CHS多见于老年体弱患者,多伴有基础疾病,多遗留后遗症;实验室检查结果显示,EHS和CHS患者出现明显的凝血功能障碍,且以EHS患者更严重,这可能是EHS致多器官功能障碍的主要发病机制.
目的 對近8年來筆者所在醫院收治的勞力性熱射病(exertional heatstroke,EHS)和非勞力性熱射病(classic heatstroke,CHS)患者臨床資料進行比較分析、總結.方法 收集2006年-2013年入住解放軍89醫院的熱射病患者23例,其中勞力性熱射病患者13例,為EHS組;非勞力性熱射病患者10例,為CHS組.另選取8例同時期的輕中度中暑患者為對照組. 記錄分析納入本研究患者的一般資料、實驗室檢查指標和臨床治療措施以及預後等,運用統計學方法比較分析三組患者的血常規、凝血四項檢驗指標的變化情況. 結果 CHS組患者較EHS組和對照組平均髮病年齡偏高,基礎疾病多,後遺癥多;三組白細胞(white blood cell,WBC)計數均較正常值[(4~10) ×109/L]偏高,但組間比較無顯著性差異(P>0.05);EHS 組患者入院時血小闆(platelet,PLT)計數明顯低于對照組(P<0.05),住院期間PLT峰值明顯低于對照組和CHS組,P<0.05,差異有統計學意義;EHS組患者入院時凝血酶原時間 (thrombin time,PT)、 活化部分凝血酶原時間 (activated partial thromboplastin time,APTT) 及住院期間PT、APTT峰值與CHS組和對照組比較明顯延長,P<0.05, 差異有統計學意義;CHS患者入院時PT、APTT及住院期間PT、APTT峰值與對照組比較無顯著性差異(P>0.05).結論 CHS多見于老年體弱患者,多伴有基礎疾病,多遺留後遺癥;實驗室檢查結果顯示,EHS和CHS患者齣現明顯的凝血功能障礙,且以EHS患者更嚴重,這可能是EHS緻多器官功能障礙的主要髮病機製.
목적 대근8년래필자소재의원수치적로력성열사병(exertional heatstroke,EHS)화비로력성열사병(classic heatstroke,CHS)환자림상자료진행비교분석、총결.방법 수집2006년-2013년입주해방군89의원적열사병환자23례,기중로력성열사병환자13례,위EHS조;비로력성열사병환자10례,위CHS조.령선취8례동시기적경중도중서환자위대조조. 기록분석납입본연구환자적일반자료、실험실검사지표화림상치료조시이급예후등,운용통계학방법비교분석삼조환자적혈상규、응혈사항검험지표적변화정황. 결과 CHS조환자교EHS조화대조조평균발병년령편고,기출질병다,후유증다;삼조백세포(white blood cell,WBC)계수균교정상치[(4~10) ×109/L]편고,단조간비교무현저성차이(P>0.05);EHS 조환자입원시혈소판(platelet,PLT)계수명현저우대조조(P<0.05),주원기간PLT봉치명현저우대조조화CHS조,P<0.05,차이유통계학의의;EHS조환자입원시응혈매원시간 (thrombin time,PT)、 활화부분응혈매원시간 (activated partial thromboplastin time,APTT) 급주원기간PT、APTT봉치여CHS조화대조조비교명현연장,P<0.05, 차이유통계학의의;CHS환자입원시PT、APTT급주원기간PT、APTT봉치여대조조비교무현저성차이(P>0.05).결론 CHS다견우노년체약환자,다반유기출질병,다유류후유증;실험실검사결과현시,EHS화CHS환자출현명현적응혈공능장애,차이EHS환자경엄중,저가능시EHS치다기관공능장애적주요발병궤제.
Objective Clinical data of heatstroke patients which collected in author's hospital over past 8 yrs were analyzed. Methods The 23 cases of heatstroke,which collected in 89 People's Liberation Army Hospital 2006-2013,were divided into three groups: exertional heatstroke group (EHS group,13 cases),non-exertional (classic) heatstroke group (CHS group,10 cases),and 8 mild to moderate stroke cases as a control group. The general situation,clinical manifestation and lab exam parameters including blood routine test,blood clotting,liver function,renal function,muscle acid kinase were recorded and statistically analyzed. Results Compared with either EHS or control group,the CHS patients were older,more with underlying diseases and worse prognosis. White blood cells (WBC) of these three groups were increased,while there was no difference among groups (P>0.05). Platelet(PLT) of EHS patients at the beginning of admitted hospital is higher than control(P<0.05) and PLT peak was higher than control and CHS (P<0.05). Thrombin time (PT) and activated partial thromboplastin time(APTT) of EHS patients either at the beginning and the peak were longer than control and CHS(P<0.05),while there was no significant difference between CHS and control(P>0.05). Conclusion CHS is more common in older patients, and who with underlying diseases and worse prognosis. Laboratory tests show that EHS and CHS patients are with significant coagulation disorders,and EHS is more severe. Above factors may contribute to the pathogenesis of HS induced multiple organ dysfunction.
