重症中暑患者合并弥散性血管内凝血的临床分析

Clinical analysis of severe heat stroke with DIC

目的探讨重症中暑患者弥散性血管内凝血(DIC)的发生率、影响因素、合并症及治疗。方法回顾性分析我院收治的57例重症中暑患者的临床资料与救治经验。结果单因素分析显示重症中暑患者并发DIC与高温暴露时间、体温、休克关系密切,与性别、年龄无关,且发生DIC的重症中暑患者合并肝功能异常、横纹肌溶解发生率明显升高。经降温、抗休克、脏器支持等综合治疗,有5例患者死亡,治疗有效率为91.2%,其中合并DIC的患者病死率为18.2%。结论重症中暑患者合并DIC病死率高,采取集束化救治技术,控制性降温、积极抗休克和脏器保护,可有效提高抢救重症中暑患者的成功率,在DIC抗凝治疗同时需注意保护肝肾功能。

Objective To study the incidence,influence factors,complications and treatment of severe heat stroke with Disseminated Intravascular Coagulation（DIC）.Methods A review analysis of the clinical data and treatments of 57 severe heat stroke patients in our hospital was made.Results The univariate analysis indicated that severe heat stroke with DIC was closely related with the time of high temperature exposure,body temperature and shock,not with sex and age,and there also appeared abnormal liver function and an apparent rise in the incidence of striated muscle dissolution.By comprehensive treatments such as cooling,anti-shock and viscera support,only 5 patients failed to survive,and the cure rate was 91.2%.The death rate of the patients with DIC was 18.2%.Conclusion It suggests a high death rate in severe heat stroke with DIC.Bundle treatment,temperature control,active anti-shock and viscera protection can enhance the success of the treatment of severe heat stroke.The protection of liver and kidney function shouldn＇t be neglected during the DIC anticoagulant treatment.