De Ronne Nadine
Cellule stratégique médicale de Kind en Gezin, Bruxelles.
J Pharm Belg. 2010 Sep(3):53-7.
Fever represents a normal physiological response as a result of the introduction of an infectious agent producing exogenous and endogenous pyrogenes influencing the central set point of body temperature. This response is an important immunological defence. Fever can be defined as any elevation of body temperature above 38 degrees C. Infancy body temperature should be measured rectal. Fever is mostly caused by a benign viral infection, but it can be an indicator of a major illness such as meningitis, septicaemia, pneumonia. The risk for severe evolution depends on the clinical context and the age of the infant. Most predictive for major illness are situations in which infants are younger than 3 months with body temperature > or = 38 degrees C, infants between 3 and 6 months with body temperature > or = 39 degrees C, and children of any ages with critical clinical signs. Those patients should be seen by a medical doctor as soon as possible. Height and duration of fever are no predictive parameters for major illnesses. Repeated observation of the feverish child is very important in order to follow any evolution. Uncomplicated fever is harmless and should not be treated. If necessary, we prefer acetaminophen (paracetamol), given orally except in cases of vomiting. Antipyretics will not affect the cause of fever, sometimes they might make the diagnosis of the underlying cause difficult, but they may have an effect on discomfort for the child. If antipyretics have been given, repeated observations stay important. Postvaccineal fever should not be treated in a different way. Febrile convulsion is a common outcome of childhood febrile illness. Adverse effects are rare. The use of antipyretics cannot prevent initial or recurrent febrile convulsions and they should not be used for this purpose.
发热是由于引入感染因子产生外源性和内源性致热原影响体温中枢调定点而导致的正常生理反应。这种反应是一种重要的免疫防御。发热可定义为体温高于38摄氏度。婴儿体温应通过直肠测量。发热大多由良性病毒感染引起，但也可能是重大疾病的指标，如脑膜炎、败血症、肺炎。严重病情发展的风险取决于临床情况和婴儿年龄。最能预测重大疾病的情况是：3个月以下婴儿体温≥38摄氏度、3至6个月婴儿体温≥39摄氏度以及任何年龄有危急临床体征的儿童。这些患者应尽快就医。发热的高度和持续时间不是重大疾病的预测参数。对发热儿童进行反复观察对于跟踪病情发展非常重要。单纯性发热无害，不应治疗。如有必要，我们更倾向于口服对乙酰氨基酚（扑热息痛），呕吐情况除外。退烧药不会影响发热原因，有时可能会使潜在病因的诊断变得困难，但可能会缓解孩子的不适。如果已服用退烧药，反复观察仍然很重要。疫苗接种后的发热不应采用不同的治疗方式。热性惊厥是儿童发热性疾病的常见后果。不良反应很少见。使用退烧药无法预防初次或复发性热性惊厥，不应为此目的使用。
