发热待查-ppt教学课件

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1、发热FEVERRespiratoryDepartmentofTang-DuHospital,ThefourthMilitaryMedicalUniversityFuEn-QingTopicofclass1.Understandingtherangeofdiseasesrelatedtofever.2.Graspingtheconception,degrees,sortsoffever.3.Graspingpathwaysofdiagnosisandprincipleoftreatmentoffever.4.Understandingtheepid

2、emicoffever.5.Graspingcommonprincipleoftreatmentoffever.Definitionoffever:Bodytemperatureisabovenormalrangeinanycondition(36.3—37.2degreescentigradewhichismeasuredinmouth).2.Kindsofpyrogen:（1）exogenoaspyrogen外生致热原bacteria，virus，fungi真菌，Spirochete螺旋体，malarialparasite原虫，Parasit

3、e寄生虫，etal.Antigen-antibodycomplex，steroidAntigen-antibodycomplex.（2）edoogenouspyrogen内生致热原interleukin－1，2，6(IL-1~18）.TNF（Tumonecrosisfactor），IFN（Interferon）,endothelin,cilianyneurotrophicfactorCNTFIl-8,macrophageinflammatoryprotein-1MIP-1,3.体温调节（调定点学说)thermoregulationofsetpoi

4、nttheory发热激活物(substancestoactivatefver)exogenoaspyrogensAntigen-antibodycomplex抗原抗体复合物steroidcomplex类固醇复合物产EPs细胞EPs神经介质：PGE,Na/CaCRH促肾上腺激素释放激素，aVP精氨酸加压素，A-MSH,Liportin脂皮质激素-1调定点运动神经Motornerve交感神经sympatheticnerve肌紧张muscletension寒战chilling血管收缩bloodvesselcontract产热增加散热减少发

5、热fever4.发热分度：DegreesoffeverLowFever:<38.0°CMiddleFever:38.0~39.0°CHighFever:39.0~41.0°CExceedhighfever:>41.0°C5.热型：Typesfoffever)①稽留热：continuedfever持续高温②驰张热spreadfever③间隙热intermissionfever④波浪热:wavesfever⑤回归热:Recurrentfever⑥不规则热:irregularfever6.常见病因：commonpathogeny(1)感染性发热：inf

6、ectiousfever病毒virus支原体mycoplasm立克次体Rickettsia细菌Bacterium螺旋体Spirochete原虫Protozoa寄生虫Parasite真菌Fungus（2）非感染性发热：non-infectiousfverA.无菌性坏死asepticnecrosis：肿瘤tumor血液病hematopathy血栓坏死thrombo-necrosisB.机械性物理性损伤等．MechanicalandphysicalinjureC.变态反应性发热allergicreactionⅠ、Ⅱ、Ⅲ、Ⅳ型变态反应D.内分泌及代谢障碍

7、性疾病endocrinedisorderandmetabolicobstacledisease：脱水E.体温调节中枢功能紊乱heatregulatingcenterdisorder：中暑heatstroke发热病因组成：青岛医学院第二附属医院208例186例清楚诊断：89.4%,10.6%诊断不清感染117例风湿疾病:36例肿瘤:34例具体组成(见下表):2周呼吸道感染:26急性白血病3胆道感染14恶组1结核胸膜炎13SLE3肺结核10泌尿系感染10败血症6肝脓肿61-2月败血症10SLE10淋巴瘤4肺外结核8多发性肌炎6肝癌4肝脓肿7Still

8、病5恶组6泌尿系感染4类风湿3肾癌3脾脓肿1急性白血病22-3月膈下脓肿1Reit综合症2肝癌2恶组3肺外结核4SLE4淋巴瘤2Stil