1、Fever（发热）（发热）1.What does body temperature mean1.What does body temperature mean？复习旧课复习旧课2.2.WhereWhere is the thermotaxic center is the thermotaxic center？The bodys internal temperatureHypothalamus体温调节中枢体温调节中枢-下丘脑下丘脑Key words Fever 发发 热热 infectious fever 感染性发热感染性发热 non-infectious fever 非感染性发热非感染性发热
2、moderate fever 中等度发热中等度发热 ultra high fever 超超 高高 热热 continued fever 稽稽 留留 热热 remittent fever 弛弛 张张 热热 intermittent fever 间间 歇歇 热热 Fever is due to various reasons,so that the body heat production and heat balance,causes the body temperature to rise beyond the normal range.Difinition 定义定义发热发热是由于各种原因使机
3、体产热和散热失衡，导致体温升高是由于各种原因使机体产热和散热失衡，导致体温升高超出正常范围。超出正常范围。1 1、Oral measurement Oral measurement 口测法口测法(36.3-37.2)(36.3-37.2)2 2、Measurement of Measurement of axillary temperatureaxillary temperature 腋测法腋测法 (36(36-37);37);3 3、Anal measurement Anal measurement 肛测法肛测法（36.5-37.736.5-37.7）Normal range of temp
4、erture 体温的正常范围体温的正常范围 24h does not exceed 1（24h不超过不超过1）Impact factors:Age Diurnal rhythm The movement,labor,dining,High temperature environment,Premenstrual etc.：Physiological fluctuations（生理性波动）（生理性波动）Classification of etiology 病因分类病因分类Caused by a variety of pathogens各种各种病原体感染病原体感染引起。引起。Bacteria细菌细
5、菌(43%)、virus病毒病毒(7%)、立克次体支原体、立克次体支原体、螺旋体、真菌、寄生虫等。螺旋体、真菌、寄生虫等。Infectious fever感染性发热感染性发热 Non-infectious fever非感染性发热非感染性发热Hyperthyrea甲状腺功能亢进；甲状腺功能亢进；Thermoregulation dysfunction 体温调节中枢异；体温调节中枢异；Aseptic necrosis of material damage or necrosis 无菌性坏死物质损伤无菌性坏死物质损伤/坏死坏死(吸收热吸收热)。最常见最常见 1.Pyrogen fever 致热源性发
6、热致热源性发热 2.Nonpyrogen fever非致热源性发热非致热源性发热Pathogenesis 发病机制发病机制 The low-grade fever：37.338moderate fever：38.139High fever：39.141Ultra high fever：41以上以上Classification 发热分度发热分度 （vRising period上升期上升期 骤升骤升 缓升缓升vThe fever stage高热期高热期vDecline period下降期下降期 骤降骤降 缓降缓降Clinical period 临床分期 Connect all the temper
7、ature records at different time into a line，this line is called fever type.将不同时间点测量的体温用直线连接，形成的曲线即为热型将不同时间点测量的体温用直线连接，形成的曲线即为热型。Fever type 热型热型 undulant fever 波状热波状热Fever typeintermittent fever 间歇热间歇热relapsing fever 回归热回归热continued fever稽留热稽留热remittent fever 弛张热弛张热 Fever type热型热型irregular fever 不规则热
8、不规则热continued fever稽留热稽留热remittent fever 弛张热弛张热over39-40,lasting a few days or weeks,temperature fluctuations will not be more than 1 in 24 hours.39-40 39-40 以上，持续数天或数周，以上，持续数天或数周，2424小时体温波动不超过小时体温波动不超过1 1 。如大叶。如大叶性肺炎、伤寒等性肺炎、伤寒等Continued fever 稽留热稽留热More than 39,temperature fluctuations will be more
9、 than 2 in 24 hours,but also more than 37.39 39 以上以上,24,24小时波动范围超过小时波动范围超过2 2 ，但在，但在37 37 以上。常见于败血症、风以上。常见于败血症、风湿热、重症肺结核及化脓性炎症。湿热、重症肺结核及化脓性炎症。Remittent fever 弛张热弛张热 The temperature soared after reaching its peak lasting several hours,then dropped to normal level,after several hours or days intermiss
10、ion,temperature rise suddenly,such repeated alternation.体温骤升达高峰后持续数小时，又骤降至正常水平，经数小时或数天间歇后，体温骤升达高峰后持续数小时，又骤降至正常水平，经数小时或数天间歇后，体温再次突然升高，如此反复交替。见于疟疾、急性肾盂肾炎等。体温再次突然升高，如此反复交替。见于疟疾、急性肾盂肾炎等。Intermittent fever间歇热间歇热1.1.Cough,sputum,chest pain Cough,sputum,chest pain 呼吸系统疾病呼吸系统疾病2.Nausea,vomiting,abdominal pa
11、in,diarrhea2.Nausea,vomiting,abdominal pain,diarrhea 急性胃肠炎急性胃肠炎.细菌性疾病等细菌性疾病等3.3.rashrash 麻疹、猩红热、水痘、风湿热等麻疹、猩红热、水痘、风湿热等Accompanying symptoms 伴随症状伴随症状v Onset condition 起病情况起病情况v Accompanying symptoms 伴随症状伴随症状v Diagnosis and treatment condition 诊治情况诊治情况v other condition 其他情况其他情况Interrogation points 问诊要点
12、问诊要点Summrize 总结总结 Master 掌握掌握 Definition of fever,normal body temperature,classification of fever,clinical significance of the common fever typeAcquaintance 熟悉熟悉The causes of fever,pathogenesis,and interrogation pointsComprehend 了解了解Clinical course of fever and the accompanying symptoms1、Is it right to take an antiphlogistic needle with a fever?2、The classification of fever？3、What is the difference between the intermittent fever and relapsing fever？Questions21
