Pyne Scott
United States Naval Academy, Annapolis, Maryland 21402, USA.
Sports Med. 2007;37(4-5):434-6. doi: 10.2165/00007256-200737040-00042.
The medical management of marathon casualties involves several potential treatment pathways. It is helpful to develop defined treatment protocols for commonly experienced conditions addressing intervention selection criteria and monitoring response to therapy. Providing intravenous (IV) fluids for runners post marathon should be scrutinised based upon the effectiveness and safety of the intervention. Commonly agreed upon indications for IV fluids are replacement for clinical dehydration and support for unconscious, hypoglycaemic or persistently hypotensive athletes. Most clinicians recommend serum sodium evaluation prior to IV initiation. IV fluid use in athletes with persistent nausea, generalised muscle cramping and to augment whole-body cooling is commonly deployed despite the paucity of supporting scientific evidence and remains an area for further study. Marathon medical support leaders should develop and disseminate guidelines to direct the administration of IV fluids at their medical aid stations.
马拉松伤员的医疗管理涉及多种潜在的治疗途径。针对常见情况制定明确的治疗方案，明确干预选择标准并监测治疗反应，这很有帮助。对于马拉松赛后的跑步者，应根据干预措施的有效性和安全性来仔细审查静脉输液的使用。普遍认可的静脉输液指征是用于临床脱水的补液以及支持昏迷、低血糖或持续性低血压的运动员。大多数临床医生建议在开始静脉输液前评估血清钠水平。尽管缺乏科学证据支持，但在有持续性恶心、全身性肌肉痉挛的运动员中使用静脉输液以及用于增强全身降温的情况仍很常见，这仍是一个有待进一步研究的领域。马拉松医疗支持负责人应制定并传播指导方针，以指导其医疗救助站的静脉输液管理。
