半程马拉松运动员比赛伤情及重症运动性中暑特点分析

Injury characteristics and severe exertional heatstroke of athletes in International Half Marathon

目的 分析历届扬州鉴真国际半程马拉松比赛的总体伤情情况及马拉松比赛中出现的重症运动性中暑病例的临床特点.方法 收集2006至2014年九届扬州鉴真国际半程马拉松比赛的参赛人数、救治人数、伤病情况.根据APACHEⅡ≥10分从中筛选出重症病例,分析重症病例的临床症状、实验室检查特点.结果 扬州国际半程马拉松比赛九届共救治649人,伤病率1.02％,其中以外伤性损伤为主,共598人(92.1％),表现为肌痉挛、肌肉拉伤、跌倒擦伤、扭伤、骨折.非外伤性损伤47人(7.9％),表现为虚脱、脱水、意识障碍、高热、休克.无死亡病例.重症病例共6例,APACHEⅡ评分15 ～ 36分;6例重症病例均表现发热、意识障碍,符合运动性中暑诊断.实验室检查出现肌酶、心肌酶、肝功能、血糖、乳酸、动脉血气等多项指标及心电图的异常.结论 扬州半程马拉松比赛中的损伤以外伤性损伤及轻症病例为主.重症运动性中暑易出现严重的横纹肌溶解、心肌损害、肝功能损害,诊治中应重点关注、早期发现、及早干预.

Objective To analyze the general injury situation and clinical characteristics of the severe exertional heatstroke of athletes in previous Yangzhou Jianzhen International Half-Marathon.Methods The data about participants,treatment and injury of the athletes from 2006 to 2014 were collected. The severe cases were screened out according to APACHEⅡ( score points ≥10) to analyzing their clinical symptoms and laboratory features. Results The total number of injuries is 649,the rate of injury is 1. 02% in Yangzhou Inseteternational Half Marathon,with traumatic injuries of 598( 92. 1%),featuring as muscle spasm,muscle injury,bruise,sprain,fracture. Non traumatic injuries only were 47( 7. 9%),featuring as exhaustion,dehydration,unconsciousness,high fever,shock. There were no death cases. There were 6 Severe cases with APACHEⅡ 15-36 score,featuring fever and unconsciousness,in line with the diagnosis of severe exertional heatstroke. There were abnormalities in laboratory tests such as muscle enzymes, enzymes, liver function, blood glucose, lactate, arterial blood gas and ECG.Conclusions Most injuries in Yangzhou Half Marathon were traumatic injury and mild cases. The severe exertional heatstroke prone to severe rhabdomyolysis,myocardial damage and liver dysfunction,for which attention should be paid to the early detection and intervention.