aap儿童发热与退热药物（中英对照版）.pdfVIP

FeverandAntipyreticUseinChildren 儿童发热和退热药物应用 Abstract 摘要 Feverinachildisoneofthemostcommonclinicalsymptomsmanagedbypediatriciansand otherhealthcareprovidersandafrequentcauseofparentalconcern.Manyparentsadminister antipyreticsevenwhenthereisminimalornofever,becausetheyareconcernedthatthechild mustmaintaina“normal”temperature.Fever,however,isnottheprimaryillnessbutisa physiologicmechanismthathasbeneficialeffectsinfightinginfection.Thereisnoevidencethat feveritselfworsensthecourseofanillnessorthatitcauseslong-termneurologiccomplications. Thus,theprimarygoaloftreatingthefebrilechildshouldbetoimprovethechild’soverall comfortratherthanfocusonthenormalizationofbodytemperature.Whencounselingthe parentsorcaregiversofafebrilechild,thegeneralwell-beingofthechild,theimportanceof monitoringactivity,observingforsignsofseriousillness,encouragingappropriatefluidintake, andthesafestorageofantipyreticsshouldbeemphasized.Currentevidencesuggeststhatthere isnosubstantialdifferenceinthesafetyandeffectivenessofacetaminophenandibuprofenin thecareofagenerallyhealthychildwithfever.Thereisevidencethatcombiningthese2 productsismoreeffectivethantheuseofasingleagentalone;however,thereareconcernsthat combinedtreatmentmaybemorecomplicatedandcontributetotheunsafeuseofthesedrugs. Pediatriciansshouldalsopromotepatientsafetybyadvocatingforsimplifiedformulations, dosinginstructions,anddosingdevices.Pediatrics2011;127:580–587 儿童发热是儿科医生及医护人员常遇见的临床症状，同时也是引发家长焦虑的常见原因 许多患儿家长会在孩子轻微发热甚至无发热的情况下使用退热药，因为他们认为孩子的体 温必须正常。发热并非一种疾病，它是机体对抗感染的一种生理机制。目前并无证据显示 发热是某种疾病的导因或会导致神经系统并发症。因此，对发热患儿的首要任务并非将体 温降至正常水平而是让孩子感到舒服。在给家长或护理人给予建议时，重点强调孩子的正 常精神状态表现，观察活动程度的重要性，关注严重疾病的症状，鼓励适当的液体摄入以 及退热药物的安全剂量。目前的证据显示，在安全性和效果方面，用于一般发热儿童的护 理的对乙酰氨基酚和布洛芬并没有显著差异。有证据显示使用2种药物比单一使用某种更 加有效；但是使用两种药物较为复杂同时易引发用药不安全事件的发生。儿科医生同时需 要通过单一剂型、严格控制剂量和喂服药物器械上保证患儿安全 INTRODUCTION 简介 Feverisoneofthemostcommonclinicalsymptomsmanagedbypediatriciansandotherhealth careprovidersandaccounts,bysomeestimates,forone-thirdofallpresenti