- 太阳中风思维导图
- 概念 (Concept)
- 重症中暑的一种极端类型
- 机体在高温环境中，因产热或吸热过多，散热障碍，导致核心体温迅速升高（通常高于40°C或104°F）
- 以中枢神经系统功能障碍为主要表现
- 常伴有多器官系统损害
- 一种危及生命的急症
- 病因 (Causes)
- 环境因素 (Environmental Factors)
- 暴露于高温高湿环境
- 长时间在烈日下暴晒
- 不通风的室内高温环境
- 个体因素 (Individual Factors)
- 体能活动 (Physical Exertion)
- 高温下进行重体力劳动或剧烈运动 (劳力性中暑 Sunstroke due to exertion)
- 适应能力差 (Poor Acclimatization)
- 未能适应高温环境
- 年龄 (Age)
- 婴幼儿 (Thermoregulation underdeveloped)
- 老年人 (Thermoregulation function declines, chronic diseases)
- 基础疾病 (Underlying Medical Conditions)
- 心血管疾病 (Cardiovascular diseases)
- 糖尿病 (Diabetes Mellitus)
- 肥胖 (Obesity)
- 精神疾病 (Mental disorders)
- 神经系统疾病 (Neurological disorders)
- 皮肤病 (Skin diseases affecting sweating)
- 药物影响 (Medication Effects)
- 影响排汗功能的药物 (e.g., Anticholinergics, Beta-blockers)
- 利尿剂 (Diuretics leading to dehydration)
- 精神类药物 (Psychotropic drugs)
- 脱水 (Dehydration)
- 睡眠不足 (Sleep deprivation)
- 饮酒 (Alcohol consumption)
- 体能活动 (Physical Exertion)
- 环境因素 (Environmental Factors)
- 临床表现 (Clinical Manifestations)
- 核心体温升高 (Elevated Core Body Temperature)
- 通常 > 40°C (104°F)
- 中枢神经系统症状 (Central Nervous System Symptoms)
- 意识障碍 (Altered Mental Status)
- 意识模糊 (Confusion)
- 定向力障碍 (Disorientation)
- 躁动不安 (Agitation)
- 谵妄 (Delirium)
- 昏迷 (Coma)
- 抽搐/惊厥 (Seizures/Convulsions)
- 共济失调 (Ataxia)
- 言语不清 (Slurred speech)
- 肌强直或肌张力障碍 (Muscle rigidity or dystonia)
- 瞳孔改变 (Pupillary changes - dilated or constricted)
- 意识障碍 (Altered Mental Status)
- 皮肤表现 (Skin Manifestations)
- 经典性中暑 (Classic Sunstroke): 皮肤热、干燥、潮红 (Hot, dry, flushed skin)
- 劳力性中暑 (Exertional Sunstroke): 皮肤可能出汗 (Skin may be sweaty)
- 循环系统 (Circulatory System)
- 心率增快 (Tachycardia)
- 脉搏强劲，随后可能变弱 (Strong pulse, may become weak later)
- 血压升高，随后可能下降导致休克 (Elevated blood pressure, may drop leading to shock)
- 呼吸系统 (Respiratory System)
- 呼吸急促 (Tachypnea)
- 消化系统 (Digestive System)
- 恶心、呕吐 (Nausea, Vomiting)
- 其他 (Others)
- 少尿或无尿 (Oliguria or anuria) - 提示肾损伤
- 横纹肌溶解 (Rhabdomyolysis) - 肌肉疼痛、无力，尿液颜色深
- 核心体温升高 (Elevated Core Body Temperature)
- 诊断 (Diagnosis)
- 病史 (History)
- 高温暴露史 (History of heat exposure)
- 剧烈活动史 (History of strenuous activity)
- 体格检查 (Physical Examination)
- 高核心体温 (High core body temperature - rectal temperature is most accurate)
- 神经系统体征 (Neurological signs - consciousness level, reflexes, etc.)
- 皮肤状况 (Skin condition)
- 实验室检查 (Laboratory Tests)
- 血常规 (Complete blood count)
- 电解质 (Electrolytes - Na, K, etc., often abnormal)
- 肾功能 (Kidney function - BUN, Creatinine, often elevated)
- 肝功能 (Liver function - AST, ALT, bilirubin, often elevated)
- 肌酸激酶 (Creatine Kinase - CK, significantly elevated in rhabdomyolysis)
- 凝血功能 (Coagulation profile - PT, aPTT, Fibrinogen, D-dimer, check for DIC)
- 动脉血气分析 (Arterial blood gas analysis - acidosis common)
- 尿液检查 (Urinalysis - myoglobinuria from rhabdomyolysis)
- 影像学检查 (Imaging - Used to rule out other causes)
- 头颅CT/MRI (Brain CT/MRI - rule out stroke, hemorrhage)
- 病史 (History)
- 治疗 (Treatment)
- 紧急处理 (Emergency Management)
- 迅速将患者转移至阴凉、通风处 (Move patient immediately to a cool, shaded, ventilated area)
- 移除衣物 (Remove clothing)
- 物理降温 (Rapid Physical Cooling)
- 冰浴 (Ice bath - most effective, target temperature 38-39°C)
- 冰袋置于大血管走行处 (Ice packs on areas with large blood vessels - neck, axillae, groin)
- 冷水擦浴并扇风 (Cold water sponging and fanning)
- 喷洒冷水并扇风 (Misting with water and fanning)
- 使用降温毯 (Cooling blankets)
- 监测生命体征 (Monitor vital signs - temperature, pulse, blood pressure, respiration)
- 药物治疗 (Medical Treatment)
- 静脉输液 (Intravenous fluids)
- 补充液体和电解质 (Replenish fluids and electrolytes - use chilled fluids if possible)
- 控制寒战 (Control shivering)
- 寒战会增加产热，可用药物如苯二氮卓类 (Shivering increases heat production, use benzodiazepines like Diazepam)
- 处理并发症 (Manage Complications)
- 纠正电解质紊乱 (Correct electrolyte imbalances)
- 保护肾功能 (Protect kidney function)
- 治疗弥散性血管内凝血 (Treat DIC)
- 控制惊厥 (Control seizures - e.g., Benzodiazepines)
- 支持呼吸循环功能 (Support respiratory and circulatory function)
- 注意：禁用退热药 (Avoid antipyretics like Aspirin or Paracetamol - ineffective for heatstroke and may worsen liver/kidney damage or clotting issues)
- 静脉输液 (Intravenous fluids)
- 紧急处理 (Emergency Management)
- 预防 (Prevention)
- 避免高温暴露 (Avoid heat exposure)
- 高温时段减少户外活动 (Reduce outdoor activities during peak heat hours)
- 待在阴凉或有空调的室内 (Stay in cool or air-conditioned indoor environments)
- 补充水分和电解质 (Hydration and Electrolyte Replenishment)
- 主动饮水，少量多次 (Drink fluids proactively, small amounts frequently)
- 喝水、运动饮料或淡盐水 (Drink water, sports drinks, or slightly salted water)
- 避免含酒精和咖啡因的饮料 (Avoid alcohol and caffeinated beverages)
- 穿着适宜 (Appropriate Clothing)
- 穿着宽松、轻便、浅色、透气的衣物 (Wear loose, light-colored, lightweight, breathable clothing)
- 循序渐进适应高温 (Acclimatization)
- 逐渐增加在高温环境下的活动时间 (Gradually increase time spent in hot environments)
- 关注高危人群 (Monitor vulnerable individuals)
- 婴幼儿、老年人、慢性病患者 (Infants, elderly, chronic disease patients)
- 合理安排工作和休息 (Plan work/activities and rest breaks)
- 高温环境下工作或运动应安排在清晨或傍晚 (Work or exercise in hot environments should be scheduled for early morning or late evening)
- 保证充足休息 (Ensure adequate rest)
- 避免高温暴露 (Avoid heat exposure)
- 并发症 (Complications)
- 肾功能衰竭 (Kidney failure)
- 肝功能衰竭 (Liver failure)
- 急性呼吸窘迫综合征 (ARDS - Acute Respiratory Distress Syndrome)
- 弥散性血管内凝血 (DIC - Disseminated Intravascular Coagulation)
- 横纹肌溶解 (Rhabdomyolysis)
- 脑水肿 (Cerebral edema)
- 持续性神经功能障碍 (Permanent neurological deficits)
- 死亡 (Death)
- 鉴别诊断 (Differential Diagnosis)
- 感染性疾病 (Infectious diseases)
- 脑膜炎、脑炎 (Meningitis, Encephalitis)
- 脓毒症 (Sepsis)
- 疟疾 (Malaria - in endemic areas)
- 神经系统疾病 (Neurological disorders)
- 中风 (Stroke)
- 癫痫持续状态 (Status epilepticus)
- 代谢性疾病 (Metabolic disorders)
- 低血糖 (Hypoglycemia)
- 药物中毒/过量 (Drug intoxication/overdose)
- 甲状腺危象 (Thyroid storm)
- 感染性疾病 (Infectious diseases)
- 概念 (Concept)
太阳中风思维导图
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