结论
1.热射病导致中枢神经系统损伤,具有致残率高、死亡率高的特点,临床神经功能缺损症状重,但颇脑影像学表现较轻。
2.高热所致中枢神经系统损害呈多部位、多类型的特点,热射病中脑细胞血管源性水肿所致中暑神经损伤干预及时可痊愈,而细胞毒性水肿易导致神经元细胞永久性损伤,遗留神经缺损后遗症。
3.热射病的急性期炎症反应具有局限性,于“最佳干预时间”窗内给予及时充分的治疗,预后较好。
4.伴有基础病史特别是神经系统疾病的热射病患者,病情进展迅速,病情重,预后差。
5.热射病所引发的SIRS致各系统损害在治疗进程中不会因核心体温的正常化及症状改善而终止,建议热射病患者持续住院治疗时间至少应>14天,此期间早期抗炎治疗及炎症介质的清除可有效改善病情,预防迟发性的神经损伤。
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