海南省成人经典型与劳力型热射病病例系列分析  

Case serial analysis of the adult classical and exertional type heat stroke in Hainan Province

作　　者：周攀豪 胡志华[3] 何碧凝 赵智梅 杜鹏举 李艳 陈晓松 ZHOU Panhao;HU Zhihua;HE Bining;ZHAO Zhimei;DU Pengju;Li Yan;CHEN Xiaosong(Emergency Department,The First Affiliated Hospital of Hainan Medical University,Haikou 570105,China;School of Emergency Trauma,Hainan Medical University,Haikou 570105,China;Intensive Care Unit,the First Affiliated Hospital of Hainan Medical University,570105 Haikou,China;Endocrine Department,Sanya People's Hospital,Sanya 572029,China;Emergency Department,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China;Department of Orthopedics,Wenchang People's Hospital,Wenchang 571300,China.)

机构地区：[1]海南医学院第一附属医院急诊科,海南海口570105 [2]海南医学院急诊创伤学院 [3]海南医学院第一附属医院重症医学科 [4]三亚市人民医院内分泌科,海南三亚572029 [5]同济大学附属同济医院急诊科,上海市200065 [6]文昌市人民医院骨科,海南文昌571300

出　　处：《中华灾害救援医学》2021年第5期966-973,共8页Chinese Journal of Disaster Medicine

摘　　要：目的探讨我国最热省份海南居民经典型与劳力型热射病患病基本特征,为科学预防提供理论依据。方法收集近十年来,海南省部分地区医院(海口、三亚、儋州、文昌、万宁、琼中、白沙、东方等)2010-2019年经典型与劳力型热射病病人完整资料,对符合资料收集要求的共计122例热射病患者的相关资料进行回顾性分析。结果通过排除与纳入标准,具有完整资料的122例热射病患者中:(1)经典型热射病41例,男性31例,女性10例,平均年龄(61.54±17.84)岁,劳力型热射病81例,男性71例,女性10例,平均年龄(40.30±14.22)岁;两种热射病类型在年龄、预后、住院时间、有无合并慢性疾病、籍贯、职业等方面比较,差异显著,有统计学意义(P<0.05),其余各项指标(性别、生命体征、意识情况、是否有并发症等)比较均无统计学意义(P>0.05)。(2)两者在红细胞(Red Blood Cell,RBC)、血红蛋白(Hemoglobin,HGB)、红细胞压积(Hematocrit,HCT)、尿酸(Uric Acid,UA)、凝血酶原时间(Prothrombin Time,PT)、PT国际标准化比值(PT-International Normalized Ratio,PT-INR)、活化部分凝血酶原时间(Activated Partial Thromboplastin Time,APTT)、丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)、肌酸激酶同工酶(Creatine Kinase-MB,CK-MB)、C反应蛋白(C-Reactive Protein,CRP)等实验室指标方面,差异显著,有统计学意义(P<0.05),其余各项指标肌酐(Creatinine,Cr)、血尿素氮(Blood Urea Nitrogen,BUN)、钾(Potassium,K)、钠(Sodium,Na)、氯(Chlorine,Cl)、白细胞(White Blood Cell,WBC)、血小板(Platelet,PLT)、降钙素原(Procalcitonin,PCT)、肌酸激酶(Creatine Kinase,CK)、肌钙蛋白I(Troponin I,CTNI)、纤维蛋白原(Fibrinogen,Fib)、总胆红素(Total Bilirubin,TBIL)、直接胆红素(Direct Bilirubin,DBIL)、间接胆红素(Indirect Bilirubin,IBIL)等比较均无统计学意义(P>0.05)。结论(1)劳力型热射病患者好发暴�Objective To explore the basic characteristics of the classical and exertional heat stroke among residents in Hainan,the hottest province in China,so as to provide a theoretical basis for scientific prevention.Methods The complete data of the classic and labor-related heat stroke patients in some hospitals in Hainan Province(Haikou,Sanya,Danzhou,Wenchang,Wanning,Qiongzhong,Baisha,Dongfang etc.)from 2010 to 2019 were collected and analyzed retrospectively.Results According to the exclusion and inclusion criteria,among 122 patients with heatstroke who had complete data:1.There were 41 cases of classical heat stroke,31 males and 10 females,with an average age of(61.54±17.84)years old;81 cases of exertional heat stroke,71 males and 10 females,with an average age of(40.30±14.22)years old.There were significant differences in age,prognosis,length of hospital stays,chronic diseases,native place and occupation(P<0.05),and there were no significant differences in other indicators(gender,vital signs,consciousness,complications etc.)(P>0.05).2.There were significant differences(P<0.05)in RBC(Red Blood Cell),HGB(Hemoglobin),HCT(Hematocrit),UA(Uric Acid),PT(Prothrombin Time),PT-INR(International Normalized Ratio),APTT(Activated Partial Thromboplastin Time),ALT(Alanine Aminotransferase),AST(Aspartate Aminotransferase),CK-MB(Creatine Kinase-MB),CRP(C-Reactive Protein)and other laboratory indicators between the two groups.No significant differences(P>0.05)were found in other indicators(Cr(Creatinine),BUN(Blood Urea Nitrogen),K(Potassium),Na(Sodium),Cl(Chlorine),WBC(White Blood Cell),PLT(Platelet),PCT(Procalcitonin),CK(Creatine Kinase),CnTI(Troponin I),FIB(Fibrinogen),TBIL(Total Bilirubin),DBIL(Direct Bilirubin),IBIL(Indirect Bilirubin)etc.Conclusion 1.The exertional heat stroke patients were more likely to be healthy male adults,who were exposed to a heat environment,engaged in strong physical labor occupation,and had no special chronic history.It was most common in non-natives;Classical heat stroke patients were more likely t

关 键 词：成人 劳力型热射病 经典型热射病 患病人数 病例系列分析 

分 类 号：R599.3[医药卫生—内科学]