血管内降温在重症中暑临床救治中的作用研究进展

Research progress of intravascular cooling in clinical treatment of heatstroke

重症中暑(HS)指在高温、高湿且空气流通缓慢的环境下或剧烈运动后导致患者核心体温高于40.5℃,同时合并脏器功能损伤的一种疾病,其发病率及致死率均较高。早期诊断、早期降温可明显改善患者预后,提高生存率,减少并发症。重症中暑的降温措施可分为血管外降温及血管内降温,血管外降温主要为体表物理降温,血管内降温主要用于不适宜物理降温或因资源短缺导致诊治不及时的患者,尤其对重症中暑降温效果较好,能明显改善患者预后。目前临床上常用的血管内降温措施主要包括血管内输注降温、血管内温度管理装置降温及持续血液净化等。该文主要从血管内降温的类别、机制、临床应用及优缺点等方面进行综述。

Heatstroke is a disease with high morbidity and mortality that causes a patient's core body temperature to be higher than 40.5℃and combined with organ dysfunction when human body exposed to high temperature,high humidity and slow air circulation environment or after strenuous exercise.Early diagnosis and early cooling can significantly improve patient prognosis,increase patient survival rate and reduce complications.The cooling measures include extravascular cooling which mainly refers to physical cooling of body surface and intravascular cooling is mainly for patients who are not suitable for physical cooling or whose diagnosis and treatment are delayed due to lack of resources,especially for patients with heatstroke,which has a better cooling effect and can improve the prognosis of patients.Currently,the commonly used intravascular cooling measures in clinical practice mainly include intravascular infusion cooling,intravascular temperature management devices cooling and continuous blood purification.This article reviews the classification,mechanism,clinical application,advantages and disadvantages of intravascular cooling.