围手术期发烧。

R Lenhardt, C Negishi, D I Sessler
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引用次数: 0

摘要

与主要由神经细胞介导的正常体温调节不同,发热是由循环热原激活的。热原可由感染性或非感染性病因引发,所有这些都可能存在于接受门诊手术的患者中。发烧是所有体温调节反应(热防御和冷防御)的设定值温度的调节升高。为了根据新升高的设定值提高核心温度,血管收缩和颤抖等寒冷防御被激活。相反,麻醉会使阈间范围变宽,从而导致体温过低。因此,全身麻醉会削弱对热原刺激的发热反应。然而,发烧和麻醉之间相互作用的确切性质还有待确定。术后发热仍然是一个主要问题。伤口感染是许多此类发烧的原因,尽管许多其他病因也有贡献。因此,初步诊断应侧重于确定发热的病因。一旦确定了这一点,治疗就可以集中在具体原因上。
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Perioperative fever.

Unlike normal thermoregulatory control, which is largely neuronally mediated, fever is activated by circulating pyrogens. Pyrogens are triggered by either infectious or non-infectious etiologies, all of which may be present in patients undergoing ambulatory surgery. Fever is a regulated elevation in the setpoint temperature for all thermoregulatory responses (warm and cold defenses). To increase core temperature according to the newly elevated setpoint, cold defenses such as vasoconstriction and shivering are activated. In contrast, anesthesia widens the interthreshold range, thus resulting in hypothermia. As a result, general anesthesia impairs the febrile response to pyrogenic stimulation. However, the precise nature of the interaction between fever and anesthesia has yet to be determined. Postoperative fever continues to be a major problem. Wound infections are responsible for many such fevers, although numerous other etiologies contribute. Initial diagnosis should thus focus on determining the etiology of fever. Once that is established, treatment can focus on the specific cause.

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Abstracts from the Scandinavian Society of Anaesthesiologists, 30th Congress, 10-13 June 2009, Odense, Denmark. Abstracts from the 29th Congress of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, 5-8 September 2007, Goteborg, Sweden. CHAPTER 7 – Brain Resuscitation Abstracts from the 28th Congress of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, Reykjavik, Iceland. Abstracts from the 27th Congress of The Scandinavian Society of Anaesthesiology and Intensive Care Medicine. August 16-20, 2003, Helsinki, Finland.
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