Heat Stroke vs Heat Exhaustion
What is Heat Stroke?
中风是一种热疾病的一种形式,也称为经典非劳累热程(NEHS)。它通常发生在婴儿,老年人和长期患病的人中。它的特征是体温高于41o°C,缺乏出汗和感觉感知改变。高于41O°C的核心温度被认为是中暑的诊断,尽管在较低体内的温度下可能会发生热潮。除了这个经典的三合会外,各种神经系统特征,例如烦躁,非理性行为,幻觉,妄想,颅神经麻痹和小脑功能障碍都与热触及有关。在持续的环境温度升高后,通常发生热潮。无法控制热量平衡的个体,例如患有低心脏储备能力的个体(老年人,缺血性心脏病,心力衰竭,先天性心脏异常)对水的摄入和损失的控制不佳(婴儿,患有皮肤疾病的患者,糖尿病)是易感的有热气。肌肉变性(横纹肌溶解)导致高钾血症,低钙血症和高磷酸血症,急性肝脏损伤,导致凝血疾病和低血糖,急性肾衰竭和肺水肿。诸如甲状腺毒性,败血症,抽搐,破伤风和诸如交感神经术等药物等临床状况会导致热量产生升高。 Burns, skin diseases and drugs like barbiturates, neuroleptics, antihistamines cause a reduced heat loss. Lack of behavioral responses like switching on a fan, drinking a cold drink which would help the thermoregulation also affects the heat balance. Either a pathological rise in heat production or a reduction of heat loss can result in elevated core body temperature. As the regulatory mechanisms are impaired the recovery phase is inefficient. Therefore, heatstroke is considered a medical emergency.
What is Heat Exhaustion?
Heat exhaustion is a form of heat illness also known as Exertional Heatstroke. It commonly occurs in individuals who engage in vigorous physical exercise in a humid and hot environment. The classic symptoms are elevated core body temperature above 41o °C, excessive sweating and altered sensory perception. Non specific symptoms such as headache, dizziness, weakness, abdominal pain, muscle cramps, nausea, vomiting and diarrhea can occur with heat exhaustion. Sometime there can be blackout and loss of consciousness preceding heat exhaustion. Patients presenting with heat exhaustion are commonly healthy young adults such as athletes, military personnel. These individual’s ability to sweat is not affected; therefore, when they present to a doctor the core body temperature is commonly well below the diagnostic 41o °C. Because the heat loss mechanisms are intact, the rate of complications is less than in heatstroke. Poor physical fitness, obesity, fatigue and lack of sleep are a few of the identified risk factors for heatstroke. Heat production during strenuous exercise can be as high as ten times the basal metabolic rate. In heat exhaustion the production of heat overwhelms the heat loss mechanisms resulting in a net elevation of core body temperature. When the strenuous exercise is stopped, the heat is dissipated via the intact heat loss mechanisms and the individual recovers.
中风和热耗尽的区别是什么?
Heat stroke and heat exhaustion are at the extreme end of the heat illness spectrum. While heat exhaustion occurs in the presence of intact regulatory mechanisms, heatstroke occurs due to altered regulatory mechanisms. While heat exhaustion is caused by vigorous exercise, heatstroke is caused by impaired heat regulation. In both situations rapid cooling, treatment of the cause and complications are essential.
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