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青少年和成人劳力性中暑的处理和预防

Authors
Francis G O'Connor, MD, MPH, FACSM
Douglas J Casa, PhD, ATC, FNAK, FACSM, FNATA
Section Editors
Daniel F Danzl, MD
Karl B Fields, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM
Translators
李晓晶, 副主任医师

引言

劳力性中暑(exertional heat illness, EHI)每年都是年轻运动员死亡的主要原因[1,2]。一份美国疾病预防控制中心(Centers for Disease Control, CDC)的报告发现，训练和比赛期间都可发生EHI，并且发病率有令人不安的上升趋势[3]；尽管采取了预防措施，但军队中劳力性热射病(exertional heat stroke, EHS)仍在增多[4]。对年轻和年长运动员及从事高强度炎热活动的其他人(如消防员、士兵、建筑工人)进行治疗的临床医生需要了解体温调节的基本生理学原理、中暑的疾病谱、预防和治疗策略，以及确定他们是否能安全返回运动或工作的当前指南。

本文将总结EHI的处理和预防。EHI的体温调节、临床表现和诊断将单独讨论，运动相关低钠血症、非劳力性热射病、恶性高热和儿童中暑也将单独讨论。 (参见“青少年和成人劳力性中暑的流行病学、体温调节、危险因素和诊断”和“运动相关的低钠血症”和“成人重度非劳力性过热(经典热射病)”和“恶性高热：临床诊断与急性危象的处理”和“神经阻滞剂恶性综合征”和“儿童热射病”和“热射病之外的儿童中暑”)

指导原则

两项关键的观察结果提示了EHS和所有类型严重中暑的处理方法[5-7]：

●中暑的严重程度在初始表现期间可能不明显。

●并发症发病率和死亡率与核心温度升高的持续时间直接相关。

                        

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Literature review current through: 2017-06 . | This topic last updated: 2015-11-04.
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