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目的：探讨影响重症中暑预后的因素及死亡原因，以指导治疗。方法：收集重症中暑患者４４例，将死亡病例与治疗好转病例的临床资料进行比较，并分析死亡原因。结果：死亡组与好转组比较，体温＞４０．５℃者，昏迷程度深者，合并基础疾病、休克、心律失常者，血Ｎａ＋、血细胞比容（Ｈｃｔ）几项指标均有显著性差异（Ｐ均＜０．０１），血Ｋ＋也有差异（Ｐ＜０．０５）。死亡原因：２４小时内主要为心、脑、循环衰竭与猝死；２４小时后主要为呼吸衰竭。结论：影响重症中暑患者预后的因素主要有体温、昏迷程度、基础疾病、心律失常、休克、低血Ｎａ＋、低血Ｋ＋、血液浓缩。治疗应针对各危险因素，应早期阻断高热引起的恶性循环，及时纠正水、电解质紊乱；防止各主要脏器的衰竭；晚期则主要预防肺部感染等并发症
Objective: To explore the factors affecting the prognosis of severe heat stroke and the causes of death in order to guide the treatment. Methods: Forty-four patients with severe stroke were enrolled in this study. The clinical data of death cases and treatment-improving cases were compared and the causes of death were analyzed. Results: Compared with the improvement group, those with body temperature> 40.5 ℃, those with deep coma, those with underlying diseases, shock, arrhythmia, blood Na + and hematocrit had significant difference P <0.01), blood K + also had difference (P <0.05). Cause of death: mainly within 24 hours of heart, brain, circulatory failure and sudden death; 24 hours after the main respiratory failure. Conclusion: The main factors affecting the prognosis of severe heat stroke patients are body temperature, coma, basic diseases, arrhythmia, shock, low blood Na +, low blood K +, blood concentration. Treatment should be targeted at various risk factors, early should be blocked by the vicious circle of high fever caused by timely correction of water and electrolyte disorders; prevent the failure of major organs; late, mainly to prevent complications such as pulmonary infection