摘要
Abstract
Objective To analyze the clinical characteristics of children with classical heat stroke,and to improve the understanding of emergency front-line medical staff on children with heat stroke and the success rate of clinical treatment.Methods The clinical characteristics,auxiliary ex-amination and treatment of a child with classical heat stroke complicated with refractory status epilep-ticus admitted to the children's intensive care unit of the people's Hospital of Yanhe Tujia Autonomous County were reviewed,and the relevant literatures at home and abroad were reviewed.Results The 10-year-old male child was transferred from the hospital because of"repeated convulsions with uncon-sciousness for 2 hours".The child had a history of high-temperature outdoor activities before onset,and the core temperature was more than 40℃ at the time of onset,accompanied by repeated convul-sions.Midazolam and phenobarbital were given for sedation and antiepileptic treatment,but the effect was not good.White blood cells,lactic acid,creatine kinase and myoglobin were detected to increase.Admission diagnosis:①classical heat stroke;②efractory status epilepticus.After admission,vol-ume expansion,cooling,endotracheal intubation,mechanical ventilation and respiratory support,in-travenous midazolam+propofol anesthesia,intravenous mannitol,hypertonic saline maintenance and other intracranial pressure reduction treatments.After treatment,the patient's condition improved,the body temperature fell to normal,and there was no recurrence of convulsions.Propofol and mid-azolam were gradually stopped.At the same time,sodium valproate sustained-release tablets were added to prevent the recurrence of epilepsy.After 3 days,invasive mechanical ventilation was re-moved,blood gas analysis and organ function were monitored to be generally normal.After 1 week,the patient was discharged from the hospital,and the outpatient department was treated with hyper-baric oxygen therapy.After 3 months' follow-up,the general condition was good,and there was no neurological dysfunction.Conclusions Classic heat stroke has the characteristics of rapid onset,rapid disease progression,and high mortality rate.It is often accompanied by central nervous system dys-function,and imaging examination often shows diffuse cerebral edema.Early identification and effec-tive cooling are key to successful treatment,and it is crucial to improve the awareness and proficiency of emergency frontline medical staff in the rescue process of this disease.关键词
儿童/热射病/难治性癫痫持续状态Key words
Children/Heat stroke/Refractory status epilepticus
