-
尊敬的各位领导，各位老师，大家下午好，我是来自专业教研室的教师林宇，今天我要
讲的内容是诊断学中的发热。
首先我们一起来看看有关发热的重点词汇。<
/p>
（
PPT
准备一张中
心单词）
。
Good
afternoon, teachers! I
’
m Lin
Yu, from Professional Teaching and Research
Office.
Today I want to talk about
Fever of Diagnostics.
在学习新课之前，我们来回忆一下在生
理学上学过的关于的人体体温的内容，这里有
3
个问题，
（
复习旧课的环节要有啊，你设计
2--
3
个问题，并准备答案
）
Before
we
learn
the
new
lesson,
let
’
s
review
what
we
have
learnt
in
Physiology
——
body human temperature. Here are two
questions:
does body
temperature mean
？
It
means the body's internal
temperature.
2
.Where is the t
hermotaxic[θ
?
:m
?
?
't?ksik]
center
？
It is in the
hypothalamus
[?ha?
p
???θ?l?
m
?
s]
.
Here
are
the
key
words
of
this
lesion.
Fever
发
热
,infectious
fever
感
染
性
发
热
,
non-infective
fever
非感染性发热
,moderate
fever
中等度发热
,ultra
high
fever
超高热
,
continued
fever
稽留
热
,remittent
fever
弛张热
,intermittent
fever
间歇热
.
发热是临床最常
见的症状之一，
90%
以上的人曾经具有发热的经历，
那么到底什么是发
热呢？当我们剧烈运动后会感觉很热，
是不是就是发热了？不是，
发热并不是依靠主观感觉
来
恒定，
因为
发热是指发热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。
Fever
is
one
of
the
most
common
clinical
symptoms,
and
more
than
90%
people
have
the
experience
of
fever,
what
is
fever?
We
feel
very
hot
after
exercise,
does
that
mean
fever?
No,
because
fever
doesn
’
t
rely
on
one
’
s
subjective
feeling.
Fever
is
due
to
various
reasons,
so
that
the
body
heat
production
and
heat
balance,
causes
the
bo
dy
temperature
to
rise
beyond
the
normal
range.
而正常范围是多少呢？临床上，我们一般采用腋测法，正常值
是
36-37
摄氏度，意思就
是通过腋
测法体温超过
37
度，就是发热。
So
what
is
the
normal
range?
In
clinical
practice,
we
often
use
the
measurement
of
axillary
[?ks
?
l
?
r
?
]
temperature,
the
normal
body
temperature
is
36~
37
℃
degrees
Celsius{
di?ɡri:
?selsi:?s]
,
that
is
to
say,
if
the
temperature
is
over
37
℃
degrees
Celsi
us
,
it
means
fever.
但是，
正常状况下，体温可随一些影响因素发生变化，比如运动、劳动、进餐后及高温
环境均会使体温增高，
妇女经前或妊娠时体温增高等等。
。
。
。
，
这是生理现
象，
并不是生病发
热，那么，导致病理发热的原因有哪些呢？<
/p>
But
generally,
body
temperature
may
change
with
some
factors,
for
example,
the
temperature of the aged is lower than
the young our temperature is lower in the morning
than
in
the
aftertoon.
Certainly,There
are
many
other
factors
can
affect
the
temperature
,such
as
the
movement,
labor,
dining,
high
temperature
environment,
premenstrual
[?pr
i:?menstru?
l]
,
pregnancy
['pre
ɡn?ns?]
and
so on, all
these
are
physiological
[?f?
z
??
'l
?
d
??
kl]
phenomenon, not fever. Thus, what cause
pathological
[?p?θ??
< br>l
?
d
??
kl]
fever?
根据发热的病因，我们将发热分为
2
大类，一类是感染性发热，比如由各种病原体
（细
菌、病毒等）引起的感染性发热。
这是导致发热最
常见的原因。
另一类是非感染性发热，比
如甲状腺功能亢进症、
体温调节中枢功能异常等。
According
to
the
causes
of
fever, fever
is
often
classified
into
2
categories
['k?
t<
/p>
?ɡ
?
r
?
z]
:
infectious
fever,
，
it is always caused
by a variety of pathogens
[?p?θ?
< br>d
??
nz]
, such
as bacteria
[b?k't
??
r
??
]
,
virus
['va
?
r
?
s]
,
it
’
s
the
most
common
cause
of
r
one
is
non-
infectious
fever,
such
as
hyperthyrea
[ha
?
p
?'θa?
r
??
]
,
thermoregulation
[?θ?
:m
???
regj
?
'le
???
n]<
/p>
dysfunction
[d
?
s'f
??k?<
/p>
n]
.
虽然我们已经知道了发热的病因
，
但这些病因到底是怎么引起发热的呢，
接下来我们学
习发热的发生机制。
大多数发热是由于致热源的作用，
< br>其中又包括内源性致热源及外源性致
热源，
这一类叫做致
热源性发热。
另一类叫做非致热原性发热，
是体温调节机制失控
或调节
障碍引起的。
Although we already know the causes of
fever, but how did they cause fever? Now
we
’
ll
learn
the
pathegenesis
[?p?θ??
d
?
< br>en
?
s
?
s]
of
fever.
Most
fever
is
pyrogen
['pa
??
r
??
d
??
n]
fever,
including
endogenous
[en?d?
d
??
n
?<
/p>
s]
pyrogen
and
exogenous
[ek's
?
d
??
n
?
s]
pyrogen.
The
other is called non-pyrogen fever, it
is caused by body temperature regulation
uncontrolled
and disorders.
在儿科的医生可能经常见到一个家长抱着一个孩子说：医生，医生，救救我的孩子啊，<
/p>
发高烧了，而一测体温
38
摄氏度，那这
是不是高热呢，接下来就谈到发热的分度。发热有
四个等级，第一，低热，体温在
37.3-38
摄氏度；第二，中等度热，体温在
38.1-39
摄氏度；
第三，高热，体温在
39.1-41
摄氏度；第四，超高热，体温在
41
摄氏度以上。
临床上对不
同程度的发热
处理方式完全不一样，
低热的病人，
可以自己多喝水，就可以使
体温下降，而
高热超高热，还可以仅仅是喝水来治疗吗？
所以发
热的分度也是本次课的重点之一。
The pediatri
cians
[?pi:d??
'tr
?
?
n]
may often see a parent
holding a child saying anxiously
['??k??
sl
?
]<
/p>
:
“Doctor,
doctor,
help
my
child,
please!
He
got
a
high
fever!”
With
taking
the
temperature of
38
℃
degrees
Celsius
, does it mean high fever with
such temperature? Now
we’ll talk about
the classification of fever. Fever is
divided into four grades: The low-grade
fever:
37.3
～
38
℃
degrees
Celsius
,
moderate
[?m?
d
?
r
?
t]
fever:
38
.1
～
39
℃
,
high
fever:
39.
1
～
41
℃
,
ultra high fever: over 41
℃
.
In clinical practice, we have different treatment
to
varying degrees of fever, low-grade
fever patients can drink more water to bring down
the
temperature. As for high-grade
fever patients, could he just drink water? Of
course not! So
classification of fever
is one of the important points.
而根据发热过程
的特点，
我们将发热分为三个时期，即体温上升期、高热期、
体
温下降
期。
According
to
the
characteristics
[
?k?r?
kt
?
'r
?
st
?
k]
of
fever
process
[pr
?
'ses]
,
we
divided
fever into three
periods: rising period, the fever stage and
decline period.
体温作为生命体征之一，
在
每一个临床科室都是常规监测的项目，
我们将每一天不同时
间监
测记录下来的
体温数值连接成线，
我们发现，
< br>不同疾病的发热所形成的的曲线图都有自
己特有的规律和特点，
< br>我们将这样的体温曲线做热型。
许多发热性疾病具有比较典型的热型，
因此，
熟练掌握常见热型的特点和临床意义可以
为我们诊断疾病和护理病人提供巨大的临床
价值。
As one of the vital
< br>['va
?
tl]
signs, temperature is a routine
[ru:?ti:n]
monitoring
['m
?
n
?
t
?
r
??]
item
['a
?
t
?
m]
in
every
clinical
t
all
the
temperature
records at
different
time
into
a
line,
this
line
is
called
fever
type.
Many
febrile
[?fi:bra?
l]
diseases
have
typical
[?t?
p
?
kl]
fever
type,
so
mastering
the
characteristics
and
clinical
significance
of
fever
can
provide great clinical value for us to
diagnose disease and care for patients.
热型主要有以下
6
< br>种，稽留热、弛张热、间歇热、波状热、回归热、不规则热。其中要
求大家重点掌
握的是前三种热型。接下来我就重点为大家讲解这三种热型。
There are 6 main
fever
types: continued fever, remittent
[r
?
'm
?
t
?
nt]
fever, intermittent