Rohe Steven T
David R. Ray Branch Medical Clinic, Quantico, Virginia, USA.
JAAPA. 2012 Jun;25(6):34, 36-8. doi: 10.1097/01720610-201206000-00007.
Exercise-induced heat stroke is defined as core temperature greater than 104 degrees F (400 degrees C) accompanied by signs or symptoms of organ system failure, most commonly CNS dysfunction. Exertional heatstroke is a life-threatening emergency that requires immediate whole-body cooling for a satisfactory outcome. Cooling should be initiated and, in the absence of life-threatening complications, completed on site prior to evacuation to an emergency department or other facility. Cool-water immersion provides the fastest whole body cooling rate and the lowest morbidity and mortality for exertional heat stroke. When water immersion is unavailable, ice water towels combined with ice packs on the head, trunk, and extremities provide effective but slower whole-body cooling. Medications, including antipyretics and dantrolene, are not effective in treating heatstroke and should not be used. Clinical observations indicate that prognosis is closely linked to the amount of time a patient's temperature remains elevated. Prevention strategies are essential to reducing the incidence of exertional heatstroke, heat exhaustion, and exercise-associated muscle cramping.
运动性热射病定义为核心体温高于104华氏度（40摄氏度），并伴有器官系统衰竭的体征或症状，最常见的是中枢神经系统功能障碍。劳力性热射病是一种危及生命的急症，需要立即进行全身降温才能取得满意的治疗效果。应立即开始降温，在没有危及生命的并发症的情况下，在转运至急诊科或其他医疗机构之前，应在现场完成降温。冷水浸泡可提供最快的全身降温速度，且劳力性热射病的发病率和死亡率最低。当无法进行冷水浸泡时，用冰水冷敷毛巾并在头部、躯干和四肢放置冰袋可提供有效的全身降温，但速度较慢。包括退烧药和丹曲林在内的药物对治疗热射病无效，不应使用。临床观察表明，预后与患者体温持续升高的时间密切相关。预防策略对于降低劳力性热射病、热衰竭和运动相关肌肉痉挛的发生率至关重要。
