Yagi Keiichi, Kim Soong-Ho
Yokohama City Minato Red Cross Hospital.
Nihon Rinsho. 2012 Jun;70(6):963-8.
Immediate cooling and support of organ-system function are the two main therapeutic objectives in patients with heat stroke. When cooling is rapidly initiated and both the body temperature and cognitive function return to the normal range within an hour of onset of symptoms, most patients recover fully. Immersion in an ice-water bath is the most effective cooling method, and evaporative cooling is a rapid and effective alternative. To prevent the development of rhabdomyolysis-induced acute renal failure, aggressive IV rehydration should be continued for first 24 to 72 hours with the goal of maintaining a minimum urine output of 2 mL/kg/h. Treatment of heat cramps also consists of fluid and salt replacement (PO or IV) and rest in a cool environment. In severe cases, IV magnesium sulphate may be effective to relieve muscle cramping.
立即降温并支持器官系统功能是中暑患者的两个主要治疗目标。当迅速开始降温且体温和认知功能在症状出现后一小时内恢复到正常范围时，大多数患者可完全康复。浸入冰水浴是最有效的降温方法，蒸发散热是一种快速有效的替代方法。为防止横纹肌溶解引起的急性肾衰竭，应在最初24至72小时内积极进行静脉补液，目标是维持最低尿量2毫升/千克/小时。热痉挛的治疗还包括补充液体和盐分（口服或静脉注射）以及在凉爽环境中休息。在严重情况下，静脉注射硫酸镁可能有效缓解肌肉痉挛。
