0～5岁儿童急病因不明发热诊断处理.pptVIP

儿童急性发热的评估及处理;主要内容;主要内容;发热是儿童常见症状;儿童急性发热病因判别具有重要意义;诊断过程应寻找发热病因;诊断过程需思考的临床问题;儿童发热临床评估预警分级;提示严重疾病的相应症状和体征;实验室检查对诊断具有重要意义(1)---毛细血管充盈时间(CRT)与疾病严重程度密切相关; 实验室检查对诊断具有重要意义(2)---细胞分类计数对细菌感染的诊断价值;实验室检查对诊断具有重要意义(3)---CRP在发热患儿中的临床诊断意义;实验室检查对诊断具有重要意义(4)---降钙素原(PCT)在发热患儿中的临床诊断意义;小于3个月的发热患儿的临床评估建议;急性发热儿童诊断建议 ;主要内容;发热对人体的影响;退热处理面临的临床问题;什么情况下需要退热处理？;物理降温的方式;高热时推荐物理降温与退热药联用;儿童常用的退热药及推荐剂量;严重持续高热患儿可采用交替用药;对乙酰氨基酚的主要副作用 ;We have previously proposed that acetaminophen use might influence asthma pathogenesis through depletion of glutathione, a major antioxidant in the Airways. First, the toxic metabolite NAPQI may increase oxidative stress causing epithelial damage and increased airway inflammation. Second, in vitro, the equivalent of therapeutic doses of acetaminophen can reduce intracellular concentrations of GSH in human alveolar macrophages which, in antigen presenting cells, leads to preferential Th2 cytokine responses.;Another possibility is that acetaminophen causes airway epithelial damage through its actions as a selective cyclooxygenase-2 (COX-2) inhibitor, since it has been proposed that COX-2 plays an important role in repair of damaged airway epithelium. Recently, a novel mechanism has been proposed. A study in mice showed that the equivalent of therapeutic doses of acetaminophen produced detectable concentrations of NAPQI in the lung. NAPQI,in turn, stimulated the transient receptor potential ankyrin-1(TRPA1) which caused neurogenic airway inflammation;布洛芬的主要副作用 ;其他退热剂副作用;退热剂临床应用疑问(1)---是否可以用糖皮质激素退热?;糖皮质激素在CAP中的应用指证;难治性MPP的机制;指南推荐甲泼尼龙用于儿童重症CAP的用法用量;*;*;*;*;*;*;退热剂临床应用疑问(2)---退热剂是否能有???预防热性惊厥的发生？;;FS的现场处理;FS复发的防治 ;间歇短程预防;间歇短程预防;长程连续用药;谢谢