열사병의 임상적 특징 및 예후에 관한 연구

Clinical Characteristics and Prognosis of Heat Stroke

  • 박노한 (경북대학교 의과대학 응급의학교실) ;
  • 류현욱 (경북대학교 의과대학 응급의학교실) ;
  • 서강석 (경북대학교 의과대학 응급의학교실) ;
  • 박정배 (경북대학교 의과대학 응급의학교실) ;
  • 정제명 (경북대학교 의과대학 응급의학교실)
  • Park, Noh Han (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Ryoo, Hyun Wook (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Seo, Kang Suk (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Park, Jung Bae (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Chung, Jae Mung (Department of Emergency Medicine, School of Medicine, Kyungpook National University)
  • 투고 : 2006.09.18
  • 심사 : 2006.11.13
  • 발행 : 2006.12.30

초록

Purpose: The aim of this study was to evaluate the clinical characteristics of classic heat stroke in Korea and to identify factors of prognosis for heat stroke by comparing a survival group with a non-survival group. Methods: We retrospectively analyzed 27 patients with heat stroke who visited the Emergency Department of Kyungpook National University Hospital from March 2001 to February 2005. First, we divided the patients into two groups, the classic heat stroke group and the exertional heat stroke group, and compared them. Second, we compared the survival group with the non-survival group. Age, sex, cause, place where patients were found, underlying diseases, cooling time, performance of endotracheal intubation, initial Glasgow Coma Scale, initial vital sign, and laboratory findings were reviewed. Results: Five of 27 patients in heat stroke died. The classic heat stroke group had 20 patients. They were old and had more patients in the bathroom than the exertional heat stroke group had. The non-survival group showed lower blood pressure, lower initial GCS score, and higher respiratory rate than the survival group. In laboratory findings, the non-survival group also showed lower$HCO_3-$ level, lower albumin level, lower glucose level, more prolonged PT, and higher CK-MB level than the survival group. Delay in recognition of heat stroke and cooling were poor prognostic factors in heat stroke. Conclusion: The classic heat stroke group had patients who were old and found in the bathroom. Early recognition and treatment of heat stroke is important to reduce mortality. Cooling time, initial GCS score, mean arterial pressure, resipratory rate, $HCO_3-$, PT, CK-MB, and albumin seem to be meaningful when forming a prognosis for heat stroke patients.

키워드

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