发烧恐惧症？ 孩子体温升高时医生的建议

The American Academy of Pediatrics has some advice for parents who get all hot and bothered by a child's fever:

Chill out.

In a myth-busting new report, the academy advises against treatment every time a kid's temperature inches up.

"There's a lot of parental anxiety about fever. It's one of the most common reasons people bring their child to the doctor," said Dr. Henry Farrar, co-author of the report and an emergency room pediatrician at Arkansas Children's Hospital.

There is no proof that untreated fevers lead to seizures or brain damage. Nor is there evidence that lowering fevers reduces illness, according to the report, which focused on children older than 3 months.

Temperatures under 100.4 degrees are not considered fever. There's no harm in treating a true fever with over-the-counter acetaminophen or ibuprofen. And it makes sense to do so when the child is feeling ill. But the No. 1 reason to use fever-reducing medicine is to make a sick child feel more comfortable, the authors said.

The report - released online Monday in the journal "Pediatrics" - emphasizes that fever is not an illness but a mechanism that helps fight infection. Fevers can slow the growth of viruses and bacteria, and enhance production of immune-system cells.

"The fact is, no one has ever been able to say that a fever below a certain point is not associated with a serious infection, or that a fever above a certain point is associated with a serious infection," Farrar said.

Many experts recommend calling the doctor if a child's temperature hits 104 degrees, but Farrar said parents should pay attention to symptoms, such as whether the child is cranky, lethargic, or not drinking liquids and avoiding food. Those are often better measures of how sick a child is and whether medical attention should be sought, the authors said.

Co-author Dr. Janice Sullivan said infants younger than 3 months are an exception. Parents should get medical help when their temperatures rise above 100.4 because infants can be very sick without showing obvious signs, said Sullivan, a pediatrics and clinical pharmacology professor at the University of Louisville.

Another exception is kids with heat stroke - a medical emergency with symptoms including fever higher than 104 degrees, hot dry skin and rapid pulse caused by overexposure to heat and not enough fluids.

Children with special medical needs, including certain heart conditions, also should be seen by a doctor when their temperatures are mildly elevated, Sullivan said.

And when giving kids fever-reducing medicine, Sullivan said parents should be sure to use correct dosing devices, not kitchen teaspoons, which vary widely in size and lead to undertreatment and overtreatment.

But the biggest cause of overtreatment? Over-worried parents.

- Posted by David W Freeman，CBS News，HealthWatch.

退烧应以儿童舒适为目的

    有关研究显示，父母对儿童发烧的恐惧，即所谓的“发烧恐惧症”导致了退烧药对乙酰氨基酚和布洛芬的大量应用。

    许多家长错误地认为，儿童发烧是极危险的，可能导致大脑损伤或惊厥，因此需要立即治疗。然而，纽约联合医院医学中心儿科主任 Jeffrey L. Brown 医生说：“只有外源性儿童发烧，如大热天闷在车厢里引起中暑时的发烧，才与大脑损伤相关。内源性发烧一般不会造成大脑损害。”

    Brown 医生指出，有关研究表明，过度治疗发烧并不能预防儿童惊厥，而且这种惊厥与大脑损伤和学习能力低下无关。但对于六个月以下的婴儿，发热可能意味着严重的问题，父母应立即带婴儿去就诊。

    美国儿科学会药物委员会主任 Richard Gorman 医生指出，发烧的治疗应严格限制为以儿童舒适为目的。但经常在临床上见到的情况是，当孩子已经舒适时，医生还进行过度的治疗。他认为，如果儿童体温达38.8℃，但舒适地躺在沙发上，那么无需对其发烧进行治疗；如果儿童呈痛苦、烦躁、激惹表现，那么，医生建议在温度超过38.3℃时应予以治疗。多项研究表明，不治疗低烧实际上可能有助于儿童更快地消除感染。体温升高是身体防御机制的一部分，它使身体成为一个不利于病毒或细菌生存的宿主。