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凡遇严重高烧病人,临床常用冰敷来加速散热即所谓“积极冷却”(enthusiatic cooling)。但这种降温技术的合理性和实践效果是有问题的。我们知道,高热时的体温升高是出于肌肉产热量增加和周围血管痉挛散热减少的联合引起。而使用冷敷却可起相反的作用,因为冰不仅使皮肤受冷引起血管收缩,降低皮肤的散热功能,而且寒冷将刺激更多产热和寒战。如使用500ml 冷水从4℃升到40℃可减少热量18仟卡。如果500ml 冰水的减少热量可增至60仟卡。但500ml 水若被蒸发则可减少热量291仟卡。因此目标是尽可能多地蒸发皮肤表面的水份而避免血管收缩。
Encounter severe fever, the clinical use of ice to accelerate the heat that the so-called “active cooling” (enthusiatic cooling). However, the rationality of this cooling technology and practical effect is a problem. We know that elevated body temperature during hyperthermia is caused by a combination of increased muscle production and reduced heat dissipation from peripheral vasospasm. The use of cold but can have the opposite effect, because the ice not only causes the skin to cause vasoconstriction cold, reduce the cooling function of the skin, and the cold will stimulate more heat and chills. If the use of 500ml cold water from 4 ℃ to 40 ℃ can reduce the heat 18 kcal. If 500ml of ice water to reduce the heat can be increased to 60 kcal. However, 500ml of water if it is evaporated can reduce the calories 291 thousand cards. Therefore, the goal is to evaporate as much moisture on the surface of the skin as possible to avoid vasoconstriction.