Axelrod P
Section of Infectious Diseases, Temple University School of Medicine, Philadelphia, PA 19140, USA.
Clin Infect Dis. 2000 Oct;31 Suppl 5:S224-9. doi: 10.1086/317516.
Although physical methods of cooling are the treatment of choice for hyperthermia, their value in the treatment of fever remains uncertain. Methods involving convection and evaporation are more effective than those involving conduction for the treatment of hyperthermia. These same methods, combined with antipyretic medication, are preferable to immersion as treatment for fever in young children but are generally not practical in adults. Febrile children treated with tepid-water sponging plus antipyretic drugs are more uncomfortable that those treated with antipyretic drugs alone, although they exhibit slightly more rapid reductions in temperature. When febrile, seriously ill patients are externally cooled and are sedated or paralyzed with drugs that suppress shivering, they may have a more rapid reduction of fever and reduced energy expenditure than if treated with antipyretic drugs alone. A risk/benefit assessment of the consequences of such treatment is not yet possible.
虽然物理降温方法是治疗高热的首选，但它们在治疗发热方面的价值仍不确定。对于高热治疗，涉及对流和蒸发的方法比涉及传导的方法更有效。这些相同的方法与退烧药联合使用，作为幼儿发热的治疗方法比浸泡法更可取，但在成人中通常不实用。用温水擦浴加退烧药治疗的发热儿童比仅用退烧药治疗的儿童更不舒服，尽管他们的体温下降略快。当发热的重症患者接受外部降温，并使用抑制寒战的药物进行镇静或麻痹时，与仅用退烧药治疗相比，他们可能发热下降更快且能量消耗减少。目前尚无法对此类治疗后果进行风险/效益评估。
