| Objective: The clinical data of the patients with heat stroke in the emergency department of Xi Jing Hospital of Air Force Medical University for nearly 5 years were analyzed.At the same time,the statistical method was used to analyze clinical data of patients with Heatstroke.Comparison and analysis of laboratory data between two groups of exertional heatstroke and classic heatstroke,survival group and death group of heatstroke were down in this paper.Objective to analyze the risk factors of heat stroke survival,explore ways to identify risk factors early,and provide ideas for clinical treatment of heat stroke.Method: The clinical data of heatstroke patients from January 1,2013 to November 30,2017 in the Emergency Department of Xi Jing Hospital were analyzed retrospectively,including sex,age,year and month of the disease,the status of people,the degree of heat stroke,and the number of days of treatment in the emergency department and so on.At the same time,patients were divided into groups according to the degree of heat stroke(precursor,mild and severe)and the status of people(local residents and military officers and soldiers).The epidemiological data of heatstroke patients were statistically analyzed in each group.In addition,we have a further systematic analysis of the patients with heatstroke.The clinical data and laboratory tests were compared and analyzed between two groups of exertional heatstroke and classic heatstroke,survival group and death group of heatstroke,analysis of correlation between early laboratory test index abnormalities and heat stroke death.Result: Part one 1.In the last 5 years,255 cases of heatstroke were treated,male(68.6%);The age range is from 14 to 87 years old,with an average of 38.6 ± 19.5 years old;Among them,there were 179 cases of local residents,76 military officers and soldiers;The time of treatment for patients was 2days.2.Only 7 cases of patients with heatstroke in 2013,up to 122 cases(47.8%)in 2017;at the same time,we found that the onset months of heatstroke are mainly concentrated in May to August,with 117 cases(45.9%)in July.3.The average age of the patients with precursor heatstroke was 33.8 ± 16.3 years old,the time of treatment was 1 days;Heatstroke patients with mild symptoms were 35.3 ± 19.4 years old.The time of treatment was 2 days;the severe heatstroke patients were 49.8 ± 18.6 years old.The time of treatment was 3days.4.The age of heatstroke patients in local residents was 45.6 ± 19.3 years old,which was significantly higher than that of military officers and soldiers at 22.1 ± 3.4 years.The onset time of local residents’ heatstroke mostly occurred in 7~8 months,while the officers and soldiers in the army occurred in 5~6 months.There was a significant difference in the monthly composition.5.With local residents,there were 41.9% of precursor heatstroke,and 26.3% of severe heatstroke;meanwhile,among the military personnel,there were 67.1% of precursor heatstroke,and only 9.2% of severe heatstroke.Statistical analysis showed that the constituent ratio of heatstroke in the two groups was significantly different.Part two 1.There were 64 were diagnosed with heat shooting,including 50 males(78.1%),14 females(29.1%).The average age is 48 ±21.06 years from 19 to 84 years.There were 49 cases(76.6%)of local residents,8 cases of farmers(12.5%)and 7 cases of soldiers(10.9%).The incidence of disease have an increasing trend,the peak period of onset is in July and August.All patients had different degree of consciousness disorder,45 cases(70.3%)improved and 19 cases dead(29.7%).2.There were 37 Exertional Heat Stroke(EHS)cases,including 32 males and 5 females,age ranged from 19 to 69 years,with an average age of 38.78 ± 19.16 years old.27 cases of Classic Heat Stroke(CHS),including 18 males and 9 females,aged 29 to 85 years,with an average age of 61.37 ± 61.37 years old.The average age of CHS patients was significantly higher than that of EHS patients,and the difference was statistically significant(t=-4.97,P=0.000).Laboratory data analysis showed that the concentration of fibrinogen decreased,the concentration of ALT increased,the concentration of urea nitrogen increased,the concentration of serum calcium decrease and the concentration of BNP increased,the difference between EHS group and CHS group was statistical significant(P < 0.05).3.The analysis of the survival group and death group with heatstroke showed that there was a significant difference in awareness ratio between survival group and death group(X2=4.59,P=0.032).The incidence of liver failure and DIC in the death group was significantly higher than that in the survival group.In the death group,the laboratory test changes of the PT value,APPT value,D-Dimer,AST value,ALT value,urea nitrogen,creatinine,serum calcium,myoglobin and BNP were more significant than survival group,the difference was statistically significant(P < 0.05).However,there was no significant difference between the two groups in platelet,fibrinogen,total bilirubin,serum potassium,serum sodium,serum chloride,CO2 CP and creatine(P > 0.05).Conclusion: The average age of heat stroke is 38.6 ± 19.5 years,most of them are male.The incidence of patients is from May to August,showing an upward trend year by year.The average age of severe heatstroke patients is significantly higher than that of patients with precursor and mild diseases.The number of the treatment days of mild and severe patients was significantly higher than that in the premonitory heatstroke group.There are significantly differences in age,month of onset and degree of heat stroke between local residents and military officers and soldiers.The age of CHS patients was significantly higher than that of EHS patients.The damage of exertional heatstroke to the liver and blood coagulation system is more serious than the classic heatstroke.The effect of CHS on renal function and ion is more obvious than that of EHS.The consciousness disorder of death group of heat stroke patients is heavier than that of survival group.the analysis of the survival group and the death group in the heat laboratory,it was found that the early coagulation function,liver failure may be the main factors affecting the survival of the patients. |
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