主题：正宗的西医如何处理发烧(译自美国最负盛名的MAYO CLINIC的文章)[转帖]

Fever
发烧

Overview
综述

When you or your children aren't feeling well, one of the first things you may do is check for a fever. Although a fever isn't an illness itself, it's usually a sign that something's going on in your body. Yet fevers aren't necessarily bad. In fact, they seem to play a key role in helping your body fight off a number of bacterial and viral infections.

当你或者你的小孩感到不舒服的时候，也许你会做的第一件事情就是看看是否发烧了。尽管发烧本身不是病，它通常是你的身体发生了问题的一个迹象。然而发烧不一定是件坏事。事实上，发烧有可能是在帮助你的身体战胜数量众多的细菌和病毒的感染，而发烧在这个过程中起到了关键的作用。

If you're an adult, a fever may be uncomfortable, but it usually isn't dangerous unless it measures 103 F or higher. For very young children and infants, however, even slightly elevated temperatures may indicate a serious infection. In newborns, a subnormal temperature — rather than a fever — may be a sign of serious illness.

如果你不是大人的话，一次发烧也许会让你很不舒服，但是如果温度不达到103华氏度（约为39.4摄氏度）或者以上的话，一般是没有危险的。然而，对于很小的小孩以及婴儿来说，温度只要高那么一点点，也许就意味着严重的感染。对于新生的婴儿来说，不是发烧，而是低于正常温度，也许是严重疾病的一个迹象。

Because a fever can occur with many different conditions, other signs and symptoms can often help identify the cause. If you don't know why you have a fever, it's best not to try to lower your temperature. This may only mask your symptoms and make it harder to determine the cause. In addition, some experts think that aggressively treating all fevers actually interferes with your body's immune response. That's because the viruses that cause colds and other respiratory infections thrive at cool temperatures. By producing a low-grade fever, your body may actually be helping eliminate the virus. What's more, most fevers go away in a relatively short time — usually within a few days.

因为发烧能在不同情况下发生，其他迹象和症状通常都有助于辨识原因。如果你不知道自己为何发烧，最好不要试图降低体温。这样做只会掩盖你的症状，使得更难确定病因。除此而外，有些专家认为，强行降体温事实上会干扰身体的免疫反应。这是因为引起感冒和其他肺部感染的病毒在低温下繁殖得更快。事实上，身体会通过产生一个相对较低温度的发烧来帮助消灭病毒。除此而外，多数发烧通常时间较短，一般几天就没了。

Signs and symptoms
迹象和症状

A fever occurs when your temperature rises above its normal range. What's normal for you may be a little higher or lower than the average temperature of 98.6 F. That's why it's hard to say just what a fever is. But a "significant" fever is usually defined as an oral or ear temperature of 102 F or a rectal temperature of 103 F. A rectal temperature reading is generally 1 degree Fahrenheit higher than an oral reading.

在体温高于正常范围的时候，发烧就产生了。正常体温应该在37上下（上下可以稍微浮动一点）。这是为什么难以定义发烧的原因。但是一次“严重的”发烧通常可以定义为口腔或者耳朵温度为102华氏度（约为38.9摄氏度），或者直肠温度103华氏度（约为39.4摄氏度）。直肠温度的读数一般大于口腔温度1华氏度左右。

Depending on what's causing your fever, additional signs and symptoms may include:
根据引起发烧的原因，其他迹象和症状也许还包括：

•    Sweating          发汗
•    Shivering         发抖
•    Headache          头痛
•    Muscle aches      肌肉酸疼
•    Lack of appetite  缺乏食欲
•    Dehydration       脱水
•    General weakness  全身虚弱

Very high fevers, between 103 and 106 F, may cause hallucinations, confusion, irritability and even convulsions.

很高温度的发烧（介于103华氏度（39.4摄氏度）到106华氏度（41.1摄氏度）之间）也许会引起幻觉，神智不清，亢奋甚至抽搐。

Approximately four percent of children younger than age 5 experience fever-induced seizures (febrile seizures). The signs of febrile seizures, which occur when a child's temperature rises or falls rapidly, include a brief loss of consciousness and convulsions. Although these seizures can be extremely alarming, most children don't experience any lasting effects. Febrile seizures are often triggered by a fever from a common childhood illness such as roseola, a viral infection that causes a high fever, swollen glands and a rash.

大约4%的小于5岁的小孩会发生因发烧导致的痉挛（发烧痉挛）。在小孩的温度迅速地升高或者降低的时候，痉挛的症状就发生了，包括暂时失去意识以及抽搐。尽管痉挛的症状很令人焦心，多数小孩的症状不会再持续。发烧痉挛通常由这些小孩子的疾病引发，诸如红疹，病毒感染，扁桃体发炎以及皮疹。

Causes
原因

Even when you're well, your body temperature varies throughout the day — it's lower in the morning and higher in the late afternoon and evening. In fact, your normal temperature can range from about 97 to 99 F. Although most people consider 98.6 F a healthy body temperature, yours may vary by a degree or more.

甚至在身体正常的时候，体温在一天之内也会变动——早晨低，午后和夜晚高。事实上，正常体温可以在97华氏度到99华氏度（36.1—37.2摄氏度）之内变动。尽管大多数人认为98.6华氏度（37摄氏度）是健康人的体温，你的体温也许会高出或者低于这个温度1度。

Your body temperature is set by your hypothalamus, an area at the base of your brain that acts as a thermostat for your whole system. When something's wrong, your normal temperature is simply set a few points higher. The new set-point, for example, may be 102 F instead of 97 or 98 F.

体温是由体丘下部来调节的，体丘下部在脑子的底部区域，在身体的整个系统里面担任了调温器的作用。当身体发生状况的时候，体温只是被调节得高几个点。新的体温也许是102华氏度（约为38.9摄氏度），而不是原来的97或者98华氏度（36.1，36.7摄氏度）。

What happens with a fever
发烧时发生的情况

When a fever starts and your body tries to elevate its temperature, you feel chilly and may shiver to generate heat. At this point, you probably wrap yourself in your thickest blanket and turn up the heating pad. But eventually, as your body reaches its new set-point, you likely feel hot. And when your temperature finally begins to return to normal, you may sweat profusely, which is your body's way of dissipating the excess heat.

当发烧开始的时候，身体试着提高温度，你就会感到寒冷并且通过发抖来产生热量。此时，你也许会用厚的毛毯来把自己裹起来，并把取暖电毯的温度调高。但是事实上在你的身体达到新的温度时，你很可能会感到发热。在你的体温最后开始达到正常的时候，你也许会大量地出汗，这是你的身体释放高温产生热量的方式。

A fever usually means your body is responding to a viral or bacterial infection. Sometimes heat exhaustion, an extreme sunburn or certain inflammatory conditions such as temporal arteritis — inflammation of an artery in your head — may trigger fever as well. In rare instances, a malignant tumor or some forms of kidney cancer may cause a fever.

发烧通常意味着你的身体对病毒或者细菌感染的抵抗反应。有时，轻度的中暑衰竭，太阳曝晒过度或者某种炎症状况（诸如暂时的动脉炎症，譬如说脑动脉炎）也许也会引发发烧。恶性肿瘤或者某些肾癌引起发烧的几率很小。

Fever can be a side effect of some medications such as antibiotics and drugs used to treat hypertension or seizures. Some infants and children develop fevers after receiving routine immunizations, such as the diphtheria, tetanus and pertussis (DTaP) or pneumococcal vaccines.

发烧也可能是一些药物的副作用引起，譬如说抗生素和用来治疗过度紧张以及抽搐的麻醉药。一些婴儿和小孩在注射免疫针之后会引起发烧，譬如说白喉，破伤风，百日咳或者肺炎疫苗。

Sometimes it's not possible to identify the cause of a fever. If you have a temperature higher than 100.9 F for more than three weeks and your doctor isn't able to find the cause after extensive evaluation, the diagnosis may be fever of unknown origin. In most cases, though, the reason for your fever can be found and treated.

尽管在多数情况下发烧的原因能找到，并且能够得到治疗，有时还是不可能确定发烧的原因。如果你发烧超过100.9华氏度（38.3摄氏度）持续三个星期以上，并且为你治疗的医生在经过充分的诊断之后，也不能确定病因，那么诊断结果也许会是不明病因的发烧。

When to seek medical advice
何时寻求医治

Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.

发烧本身也许不是引起担忧的原因——或者说看医生的原因。然而在如下情况下，你应该为你的宝宝，小孩或者你自己寻求医治。

For infants
婴儿

An unexplained fever is greater cause for concern in infants and children than in adults. Call your baby's doctor if your baby:

相较于大人，对于婴儿以及小孩来说，不明原因的发烧是寻求医治的主要原因。如果你的婴儿：

•    Is younger than 2 months of age and has a rectal temperature of 100.4 F or higher. Even if your baby doesn't have other signs or symptoms, call your doctor just to be safe.

小于2个月并且直肠温度大于或等于100.4华氏度（38摄氏度），即便你的宝宝没有其他生病的迹象或者症状，为安全起见还是要叫医生。

•    Is older than 2 months of age and has a temperature of 102 F or higher.

大于2个月并且直肠温度大于或者等于102华氏度（38.9摄氏度）

•    Is a newborn who has a lower-than-normal temperature — under 95 F rectally.

新生儿并且温度低于正常体温——直肠温度低于95华氏度（35摄氏度）

•    Has a fever and unexplained irritability, such as marked crying when you change your baby's diapers or when he or she is moved. Some infants might have a fever and seem lethargic and unresponsive. In infants and children younger than age 2, these may be signs of meningitis — an infection and inflammation of the membranes and fluid surrounding your brain and spinal cord. If you're worried that your baby might have meningitis, see your doctor right away. Don't wait until morning to see your usual physician — meningitis is an emergency.

发烧并且不明原因的亢奋，譬如在你给宝宝换尿片的时候或者挪动宝宝的时候，宝宝嘶声裂肺地哭。一些婴儿也许正发烧并显得昏昏欲睡毫无生气。对于婴儿以及小于两岁的小孩来说，这些也许是脑膜炎的迹象——包裹脑子以及脊髓的膜质和液质的感染以及炎症。如果你担心宝宝也许得了脑膜炎，立刻寻求医治。不要等到第二天早晨才去看医生——脑膜炎是一种急症。

For children
小孩

Children often tolerate fevers quite well, although high temperatures may cause parents a great deal of concern. Still, it's best to be guided more by how your child acts than by any particular temperature measurement. If your child has a fever but is responsive and is drinking plenty of fluids and wanting to play, there's probably no cause for alarm.

尽管高温也许会引起家长很大的担忧，其实小孩通常较能忍受发烧。然而，最好是根据你的小孩的行为，而不是根据任何测得的温度来指导你。如果你的小孩发烧了，但是他还是比较活泼并且喝水很多，还想玩耍，也许你就不必担忧。

Call your pediatrician if your child is listless or irritable, vomits repeatedly, has a severe headache or stomachache or has any other symptoms causing significant discomfort. If your child has a fever after being left in a very hot car, seek medical care immediately.

如果你的小孩很倦怠或者很急躁，并一再呕吐，头很痛或者肚子痛，或者有其他使得他很不舒服的症状，请联络你的儿科医生。如果你的小孩被留在一辆非常热的车子里面呆了很久，并且发烧的话，请立即寻求医治。

Also call your doctor if fever persists longer than one day in a child younger than age 2 or longer than three days in a child age 2 or older.

如果一个小于两岁的小孩持续发烧超过一天，或者一个大于或等于两岁的小孩持续发烧超过三天的话，请联络医生。

Don't treat fevers below 101 F with any medications unless advised by your doctor.

除非医生建议，否则如果发烧低于101华氏度（38.3摄氏度）的话，不要采用任何药物治疗。

For adults
成人

Call your doctor about a fever if:
发烧时寻求医治如果：

•    Your temperature is more than 104 F
体温超过104华氏度（40摄氏度）

•    You've had a fever for more than three days
发烧超过三天

In addition, call your doctor immediately if any of these signs and symptoms accompany a fever:
此外，如果在发烧时伴随有以下迹象以及症状的话，请寻求医治：

•    A severe headache
严重的头痛

•    Severe swelling of your throat
喉咙肿得很厉害

•    Unusual skin rash
异常皮疹

•    Unusual eye sensitivity to bright light
眼睛对亮光的异常过敏

•    A stiff neck and pain when you bend your head forward
歪脖并且在头前倾时感到痛

•    Mental confusion
意识错乱

•    Persistent vomiting
持续呕吐

•    Difficulty breathing or chest pain
呼吸困难并且胸痛

•    Extreme listlessness or irritability
极端倦怠或者亢奋

•    Abdominal pain or pain when urinating
腹痛或者小便痛

•    Any other unexplained symptoms
其他不明原因的症状

Screening and diagnosis
诊断

Your doctor will likely diagnose the cause of your fever based on your other symptoms and a physical exam. Sometimes you may need additional tests to confirm a diagnosis. If your doctor suspects pneumonia, for instance, you may have a chest X-ray following your physical exam. In other cases you may have blood or urine tests to check for signs of infection.

根据其他症状并且在常规检查完之后，医生一般会诊断出发烧的原因。有时需要其他的测试来确定诊断结果。例如，如果医生怀疑肺炎的话，也许会在常规检查之后，让你来一个胸透。在其他情况下，也许会让你进行血液检查或者尿检来看是否有感染的迹象。

If you have a low-grade fever that persists for three weeks or more, but have no other symptoms, your doctor may recommend a variety of tests to help find the cause. These may include blood tests and X-rays.

如果你发烧温度不高持续三周，但没有其他症状，医生也许会建议你做些检测来帮助发现病因。这些检查也许包括血液检查以及胸透。

Complications
并发症

A rapid rise or fall in temperature may cause a febrile seizure in a small percentage of children younger than age 5. Although they're alarming for parents, the vast majority of febrile seizures cause no lasting effects.

在小于5岁的小孩中，很小一部分会因为体温迅速波动而引发痉挛。尽管小孩的状况会使父母担忧，多数痉挛不会有进一步的影响。

If a seizure occurs, lay your child on his or her side. Remove any sharp objects that are near your child, loosen tight clothing and hold your child to prevent injury. Don't place anything in your child's mouth or try to stop the seizure. Although most seizures stop on their own, call for emergency medical assistance if the seizure lasts longer than 10 minutes.

如果痉挛发生的话，让小孩侧躺。将任何扎人的东西从小孩身边拿走，解松小孩的衣物并且保护好你的小孩不要受到外物伤害。不要尝试把任何东西放在小孩的嘴巴里面来阻止小孩的痉挛。尽管大多数痉挛自动会停下来，如果痉挛超过10分钟的话，赶紧寻求医治。

If possible, try to time the seizure using your watch or a clock. Because they're so alarming, seizures often seem to last longer than they really do. Also try to note which part of your child's body begins to shake first. This can help your doctor understand the cause of the seizure. Your pediatrician should see your child as soon as possible.

如果可能的话，对痉挛的时间进行计时。因为痉挛很令人焦心，所以痉挛的时间通常显得比实际时间要长。也要注意小孩身体哪一部分先开始颤抖。这个有助于医生明白痉挛的原因。应该尽快让医生来给小孩治疗。

Treatment
治疗

Medical treatment depends on the cause of your fever. Your doctor will likely prescribe antibiotics for bacterial infections, such as pneumonia or strep throat. For viral infections, including stomach flu (gastroenteritis) and mononucleosis, the best treatment is often rest and plenty of fluids.

医治取决于发烧病因。医生很可能会对细菌感染开一些抗生素药，譬如肺炎或者喉部链锁状球菌感染。对于肠胃型流感（肠胃炎）和单核细胞增多症这些病毒感染来说，最好的治疗方法通常是休息以及大量饮水。

Your doctor may also suggest taking over-the-counter medications, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) to lower a very high fever. Adults may also use aspirin. But don't give aspirin to children. It may trigger a rare, but potentially fatal, disorder known as Reye's syndrome.

医生也许会建议你服用一些非处方药，譬如退热净( 一种替代阿司匹林的解热镇痛药，羟苯基乙酰胺)或者布洛芬(抗炎、镇痛药)来降高温。成人也许还会服用阿斯匹林(解热镇痛药)。但是不要给小孩服用阿司匹林。如果服用的话，也许会引发一种很少见但是潜在致命的神经紊乱症——雷氏综合症！

Self-care
自我治疗

Because your body loses more water with a fever, be sure to drink plenty of fluids to avoid dehydration. Water is best, but if it's hard to get your children to drink water, encourage them to drink juices or sports drinks containing electrolytes, or to eat frozen ice pops. Adults and children should also get enough rest. Don't be concerned with treating a fever just because it's a fever. Often, a low-grade fever is actually helping fight off an infection. In addition, follow these guidelines for both children and adults:

因为在发烧的时候身体失水比平时更多，一定要多喝水来避免脱水。喝水是最好的，但如果在很难喝到水的情况下，设法让孩子喝果汁、包含电解质的运动型饮料或者吃冰冻的冰汽水。大人和小孩都应该得到充分的休息。不要因为发烧是小毛病而自作聪明地进行干预。通常情况下，低烧实际上在帮助战胜感染。此外，对于大人和小孩来说，都要遵循以下指导意见：

For temperatures less than 102 F

对于小于102华氏度（38.9摄氏度）的温度

Don't use any medication for a fever in this range unless advised by your doctor. And don't give children aspirin because of the risk of Reye's syndrome. Instead, dress in comfortable, light clothing and try bathing in lukewarm water. At bedtime, cover yourself or your child with just a sheet or light blanket.

除非医师建议，否则不要服用任何药物。因为有雷氏综合症的风险，所以不要给小孩服用阿司匹林。相反地，要穿得舒服而轻松一点，泡一个温水澡。睡觉的时候，只给你或者你的小孩盖一床被单或者一条轻毯子。

For temperatures between 102 and 104 F

对于102到104华氏度之间的温度（38.9——40摄氏度）

Take acetaminophen or ibuprofen according to the label instructions or as recommended by your doctor. If you're not sure about the proper dosage, be sure to check with your doctor or pharmacist. Adults may use aspirin instead.

根据说明书或者医嘱服用退热净( 一种替代阿司匹林的解热镇痛药)或者布洛芬(抗炎、镇痛药)。如果你对剂量没有把握，一定要跟医生或者药剂师确认。成人也许可以服用阿司匹林。

Be careful not to give too much medication. High doses or long-term use of acetaminophen may cause liver or kidney damage, and acute overdoses can be fatal. If you're not able to get your child's fever down, don't give more medication. Call your doctor instead. Side effects of aspirin and other nonsteroidal anti-inflammatory drugs such as Motrin and Advil include stomach pain, bleeding and ulcers.

注意不要服药过多。大剂量或者长时期服用退热净也许会引起肝脏或者肾脏损伤，一次超量服用会导致致命的结果！如果你不能将小孩的温度将下来，不要再服用更多的药物。而是要叫医生。阿司匹林以及其他非类固醇抗炎症药物——例如Motrin和Advil——会有胃痛，出血和溃疡等副作用。

For temperatures greater than 104 F

对于超过104华氏度（40摄氏度）的温度

Give adults or children acetaminophen or ibuprofen following the manufacturer's instructions or as recommended by your doctor. Adults may use aspirin instead. If you're not sure about the dosage, check with your doctor or pharmacist. Be careful not to give too much medication.

依照药厂的说明书或者医嘱给大人或者小孩服用退热净或者布洛芬。大人也许可以用阿司匹林来代替。如果你对剂量没有把握，一定要跟医生或者药剂师确认。一定要注意不要服用过量的药物。

Acetaminophen is available in liquid, chewable and suppository forms for children, but it's often easiest to give medications in liquid form. For a small child, use a syringe with measurements on the side and a bulb on the tip. Gently squirt the medicine in the back corners of your child's mouth.

对于小孩子来说，退热净有口服液，口香糖和栓剂等几种形式选择，但通常很容易采用溶剂的方式给小孩服药。对于一个比较小的小孩子来说，可以采用边上带刻度，顶部是圆球的注射器来为他服药。轻轻地将药物推射到小孩的嘴巴里面的后部。

Use a five- to ten-minute sponge bath of lukewarm water to try to bring your own or your child's temperature down. A sponge bath is most likely to help if it's used shortly after a dosage of acetaminophen or ibuprofen, so that the medication can work to keep the fever down after the bath takes effect.

用带温水的海绵擦洗全身五到十分钟使得你自己或者你的小孩的体温降下来。在服用一剂退热净或者布洛芬之后，立刻用海绵擦身很有用，这样在擦后药效能够将温度降下来。

If your child shivers in the bath, stop the bath, dry your child and wait. Shivering actually raises the body's internal temperature — shaking muscles generate heat. If the fever doesn't moderate or your child has a febrile seizure that lasts longer than five minutes, seek immediate medical care.

如果在擦洗的时候小孩颤抖的话，不要再擦洗了，将小孩擦干并且等下来观察。颤抖实际上会升高体内的温度——抖动肌肉产生热量。如果发烧还不和缓下来或者小孩发烧痉挛超过5分钟，立刻寻求医治。

Taking a temperature
量体温

To check your or your child's temperature level, you can choose from several types of thermometers, including electronic thermometers and ear (tympanic) thermometers. Thermometers with digital readouts and those that take the temperature quickly from the ear canal are especially useful for young children and older adults. Because glass mercury thermometers harm both humans and the environment, they have been phased out and are no longer recommended.

你可以使用好几种类型的温度计来检查你自己或者你的小孩的体温状况，譬如电子温度计或者耳塞温度计。带数字读数的温度计和能从耳道迅速取得温度的温度计对于小孩或者老人来说特别有用。因为玻璃水银温度计对于人类和环境都有害处，现在已经逐步被淘汰不再建议使用了。

Although it's not the most accurate way to take a temperature, you can also use an oral thermometer for an armpit (axillary) reading. Place the thermometer in the armpit with arms crossed over the chest. Wait four to five minutes. The axillary temperature is about 1 degree Fahrenheit less than an oral temperature.

尽管使用口腔温度计来量腋窝的温度读得的数不是最精确，还是可以采用这种方式。将温度计放在腋窝里面，用胳肢窝夹住它。等四到五分钟。腋窝温度比口腔温度大约低1华氏度。

Use a rectal thermometer for infants. Place a dab of petroleum jelly on the bulb. Lay your baby on his or her tummy. Carefully insert the bulb one-half inch to one inch into your baby's rectum. Hold the bulb and your baby still for three minutes. Don't let go of the thermometer while it's inside your baby. If your baby squirms, it could go deeper and cause an injury.

要给婴儿使用直肠温度计。涂少量的凡士林在温度计上。将宝宝趴过来平放。将温度计小心地插入宝宝的直肠0.5到1英寸。静静地握住温度计和你的宝宝三分钟。当温度计在宝宝直肠里面的时候不要放开温度计。如果宝宝扭动身体的话，温度计会插得更深并伤害到宝宝。