热射病中肾损伤的发病机制及液体管理  

Pathogenesis and fluid management of renal injury in heat stroke

作　　者：林育芳 张艳宁[1] LIN Yufang;ZHANG Yanning(China Medical University,Shenyang 110122,China)

机构地区：[1]中国医科大学,辽宁沈阳110122

出　　处：《中国现代医生》2018年第24期164-168,共5页China Modern Doctor

摘　　要：热射病是由于暴露在高温高湿环境中导致机体核心温度迅速升高,超过40℃,伴有皮肤灼热,意识障碍等多器官系统损伤的严重临床综合征。热射病可致肾脏损伤,其可能的机制有电解质紊乱与氧化应激损伤、高温的毒性作用、凝血功能障碍、横纹肌溶解综合征及内毒素血症和全身炎症反应综合征。热射病治疗中的一个重要环节为液体复苏,然而由于热射病液体管理仍未统一,其规范化的治疗仍有待完善。本文就热射病肾损伤的机制及液体管理进行综述,以加深对热射病理解,为其防治奠定基础。Heat stroke is caused by the rapid increase of core body temperature, exceeding 40~C, due to exposure to high temperature and high humidity. It is a severe clinical syndrome with multiple organ system damages such as skin burning, disturbance of consciousness, etc. Heat stroke can cause renal damage. The possible mechanisms are electrolyte disturbance and oxidative stress injury, high-temperature toxicity, coagulation dysfunction, rhabdomyolysis syndrome, endotoxemia and systemic inflammatory response syndrome. An important part of heat stroke treatment is fluid resuscitation. However, due to the fact that the fluid management for heat stroke is yet not integrated, its standardized treatment still needs to be improved. In this paper, the mechanism of the renal damage caused by heat stroke and the fluid management are reviewed, in order to deepen the understanding of heat stroke and lay a foundation for its prevention and treatment.

关 键 词：热射病 肾损伤 发病机制 液体管理 

分 类 号：R316[医药卫生—基础医学]