本文關鍵詞： 重癥中暑 MODS 凝血異常 低分子肝素 熱休克蛋白 MOF　出處：《泰山醫(yī)學院》2014年碩士論文　論文類型：學位論文

【摘要】：目的:中暑指的是身體在高溫或熱輻射的環(huán)境下,機體出現(xiàn)調節(jié)和代謝障礙,并引發(fā)機體的水、電解質代謝紊亂及其他器官功能損害的癥狀。中暑的主要表現(xiàn)是患者的體溫調節(jié)中樞功能障礙,并伴有汗腺功能衰竭等并發(fā)癥狀。從臨床表現(xiàn)的嚴重程度來說,中暑可以分為先兆中暑、輕癥中暑和重癥中暑。其中重癥中暑包括了熱痙攣、熱衰竭和熱射病。中暑中最為嚴重的類型就是熱射病。重癥中暑后往往伴隨多器官功能的損害,治療不及時極有可能導致不可逆的臟器損害,遺留后遺癥,甚至患者死亡,為了更好的總結經驗,找出規(guī)律,指導治療,現(xiàn)探討重癥中暑后人體各臟器出現(xiàn)病理損害的先后順序及其應對措施。材料與方法:回顧性分析泰山醫(yī)學院附屬醫(yī)院在2009年7月至2013年7月之間收治的12例重癥中暑并發(fā)MODS的患者的病情演變及治療經過的情況,對12例重癥中暑患者行進常規(guī)檢查,發(fā)現(xiàn)其中凝血異常1-3日發(fā)生率為100%、100%、100%;12例重癥中暑患者中心肌損傷1-3日發(fā)生率分別為:67%、83%、100%;腦損害影像陽性率為0、0、25%;急性肺損傷發(fā)生率分別為0、8%、17%;其中腎功損害1-3日發(fā)生率分別為:42%、58%、67%;12例重癥中暑患者中消化系統(tǒng)肝損害1-3日發(fā)生率分別為:58%、83%、100%。結論:重癥中暑患者的各項輔助檢查指標中,凝血功能紊亂發(fā)生最早、最廣泛,在患者病情預后中起關鍵作用。
[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.
【學位授予單位】：泰山醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R594.12

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本文編號：1464226