Jiménez-Mejías M E, Montaño Díaz M, Villalonga J, Bollain Tienda E, López Pardo F, Pineda J A, González de la Puente M A
Departamento de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla.
Med Clin (Barc). 1990 Apr 7;94(13):481-6.
Seventy-eight cases of classical heat stroke (HS) seen during the summer of 1988 and 1989 have been evaluated. The diagnosis was established on the basis of classically accepted criteria (severe hyperthermia, impairment of the level of consciousness, anhydrosis, exposure to high environmental temperature). 62.8% of patients were females, with a mean age of 75 +/- 12.3 years. All patients had predisposing factors and 57.7% was taking facilitating drugs. 86% of the patients had 2 or more predisposing or facilitating factors. In 45 cases there were prodromic features. The suspicion of HS was not raised in any of the referring services. Hyperglycemia was present in 89.7% of cases, increased blood urea in 85.9%, high creatine kinase in 74.3%, abnormal coagulation in 52.9%, hypernatremia in 46.2%, hyponatremia in 37.2%, hypokalemia in 35.9%, hyperkalemia in 23.1%, metabolic acidosis in 41.1% and respiratory alkalosis in 36.9%. Electrocardiogram was abnormal in 95.4%. 31 patients (39.7%) died. Death was more common in patients with deep coma, shock, and higher blood urea levels. The present study demonstrates the occurrence of this condition in our area.
对1988年和1989年夏季期间收治的78例典型中暑病例进行了评估。诊断依据经典认可的标准（严重体温过高、意识水平受损、无汗、暴露于高温环境）确立。62.8%的患者为女性，平均年龄为75±12.3岁。所有患者均有诱发因素，57.7%的患者正在服用促进发病的药物。86%的患者有2种或更多的诱发或促进因素。45例患者有前驱症状。转诊科室均未提出中暑的怀疑。89.7%的病例存在高血糖，85.9%的病例血尿素升高，74.3%的病例肌酸激酶升高，52.9%的病例凝血异常，46.2%的病例高钠血症，37.2%的病例低钠血症，35.9%的病例低钾血症，23.1%的病例高钾血症，41.1%的病例代谢性酸中毒，36.9%的病例呼吸性碱中毒。95.4%的患者心电图异常。31例患者（39.7%）死亡。深度昏迷、休克和血尿素水平较高的患者死亡更为常见。本研究证明了该疾病在我们地区的发生情况。
