Barthel H J
Department of Family Practice, U.S. Army Health Clinic, Schofield Barracks, Hawaii.
Mil Med. 1990 Mar;155(3):116-9.
Heat stroke is a medical emergency characterized by sudden loss of consciousness and by failure of the heat-regulating mechanism, as manifested by high fever (usually above 104 degrees F) and cessation of sweating. Fatality rates for patients with heat stroke can vary from 0% to more than 40%. Immediately after heat stroke has occurred or is suspected, aggressive cooling measures should be initiated. This case illustrates a 24-year-old commissioned officer who developed heat stroke while running in PT formation dressed with shorts and a T-shirt. Although this patient was in good shape and the wet bulb was only 74.4 degrees F, he developed the classic symptoms of heat stroke, with a core temperature of 105.9 degrees F. He further developed hepatic and skeletal muscle enzyme abnormalities (SGOT, 4680; CPK, 327; LDH, 821) with hyposphosphatemia (0.8). This patient had no significant risk factors, and after the appropriate treatment, his enzyme abnormalities returned to normal without sequelae. This paper will discuss symptoms, predisposing factors, complications, treatment, and prevention of heat stroke--a topic that is important to all military physicians, especially to those deployed to hot, humid environments.
中暑是一种医疗急症，其特征为突然意识丧失以及体温调节机制失灵，表现为高热（通常高于104华氏度）和出汗停止。中暑患者的死亡率可在0%至超过40%之间变动。中暑发生后或被怀疑发生中暑后，应立即采取积极的降温措施。本病例介绍了一名24岁的授衔军官，他在穿着短裤和T恤进行体能训练跑步时发生了中暑。尽管这名患者身体状况良好，湿球温度仅为74.4华氏度，但他出现了中暑的典型症状，核心体温达105.9华氏度。他还进一步出现了肝和骨骼肌酶异常（谷草转氨酶4680；肌酸磷酸激酶327；乳酸脱氢酶821）以及低磷血症（0.8）。该患者没有显著的危险因素，经过适当治疗后，他的酶异常恢复正常，未留下后遗症。本文将讨论中暑的症状、诱发因素、并发症、治疗及预防——这一话题对所有军队医生都很重要，尤其是对那些部署到炎热潮湿环境中的医生。
