高溫環境之隱形殺手－中暑

Heat Stroke-Hot Working Environment Related Illness

王裕惟(Yu-Wei Wang) ； 王建楠(Jan-Nan Wang) ； 蘇世斌(Shih-Bin Su)

《中華職業醫學雜誌》 14卷2期 (2007/04) Pp. 105-109

https://doi.org/10.30027/CJOM.200704.0005

摘要

台灣雖不屬於熱帶地區，但是夏季氣溫的飆昇、濕度高、住宅密集以及老年人口的增加，發生中暑的機會也相對地提高，其中以長期工作於室外的勞工、老年人、運動員及小孩占最多數，也最易發生熱相關疾病。熱相關的疾病一般分為熱痙攣(Heat cramps)、熱衰竭(Heat exhaustion)及熱中暑(Heat stroke)。中暑的臨床表現有兩個核心症狀，即體溫過高及中樞神經系統失常。主要由於過度流汗之後，水分補充不足或過多，導致脫水及電解質不平衡，進而產生中暑症狀，若無適當的治療，將會進展到可能致死的情況。長時間於高溫環境下工作或本身有高血壓、心臟病、呼吸系統疾病、內分泌系統疾病、無汗症、腎臟疾病、廣泛性皮膚疾病或長期服藥者都是中暑的高危險群。中暑的治療以積極的降低體溫為重點，到醫院前要立即給予快速有效的外在降溫方式，在醫院時可進行注射生理食鹽水補充水分的支持性療法，如有嚴重的情況，可加上內在降溫方式治療。預防中暑的最好方法就是避免高溫的環境，維持適當的水分補充和鹽分的攝取。

關鍵字

熱中暑 ； 高溫作業 ； 熱痙攣 ； 熱衰竭

並列摘要

Although Taiwan isn't located at tropical area, heat stroke rate is still relatively prevalent due to high environment temperature, high relative humidity, some closed working environment and increased seniority. Outdoor labors, the elderly, athletes and child are more prone to suffering from heat-related illnesses. Heat-related illnesses typically are categorized as heat cramps, heat exhaustion and heat stroke. The prognosis of heatstroke rests on two critical factors: hyperthermia and central nervous system dysfunction. Profuse sweating followed by insufficient or too much fluid intake and related electrolyte imbalance may cause the progression of death if there was no adequate treatment. The high risk groups of heat stroke were persons who working in the environment with high temperature and combined with various underlying diseases, including hypertension, heart disease, respiratory system disease, endocrine system disease, anhydrosis, renal disease, diffused skin disease and long-term medicine used. Immediate initiation of effective cooling is crucial in a patient with heatstroke. Rapid and effective external cooling methods must be used in the field. In the emergency department, initiate intravenous hydration with normal saline was used for supportive treatment. Internal cooling methods by gastric, bladder, and rectal cold-water lavage may be combined treatment if the clinical condition is severe. The best strategy to prevent heat stroke is to avoid hot environments, maintaining adequate hydration and sodium intake, and it's important for the labors.

並列關鍵字

Heat cramps ； Heat exhaustion ； Heat stroke ； Hot Working Environment