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1临床资料患者男,25岁。主因在室外高温劳作2 h后出现意识不清,昏迷4 h入院。查体:体温42℃,脉搏150/min,呼吸34次/min,血压86/46 mm Hg。患者呈深昏迷状态,全身皮肤潮红,颈项强直,四肢肌张力增高,并抽搐。实验室检查:白细胞6.69×109/L,粒细胞百分比59.9%,钠131 mmol/L,氯91 mmol/L,尿酸475 mmol/L,肌酐136 nmol/L,肌酸激酶3077U/L,出凝血功能两项:PT 12.8s,PTA 73.2%;PTR 1.164,APTT 24.4。结合患者病史及检查、检验结果,诊断为热射病
1 Clinical data Patient male, 25 years old. Mainly due to high temperature in the outdoor work 2 h after unconsciousness, coma 4 h admission. Physical examination: body temperature 42 ℃, pulse 150 / min, breathing 34 times / min, blood pressure 86/46 mm Hg. Patients showed a deep coma state, the whole body flushing, neck stiffness, limb muscle tension increased, and convulsions. Laboratory tests showed that white blood cells (6.69 × 109 / L), 59.9% granulocytes, 131 mmol / L sodium, 91 mmol / L chloride, 475 mmol / L uric acid, 136 nmol / L creatine kinase and 3077 U / Two functions: PT 12.8s, PTA 73.2%; PTR 1.164, APTT 24.4. Combined with the patient’s history and examination, test results, diagnosed as heat-jet disease