父母該如何判斷孩子的流感病情是否惡化？

The standard prescription for flu is to stay home and rest, drink plenty of fluids, and keep pain and fever under control with over-the-counter drugs like acetaminophen.

流感的標(biāo)準(zhǔn)處方是待在家里休息，喝大量液體，服用撲熱息痛等非處方藥物，控制疼痛和發(fā)熱。

But this flu season has been a particularly scary one for parents. At least 53 children across the country have died from flu-related illness, and parents need to know how to tell if a child takes a turn for the worse — and if it is time to rush to the hospital.

但對父母來說，這個流感季尤其可怕。美國至少有53名兒童死于流感相關(guān)疾病，父母需要知道如何判斷孩子的病情是否開始惡化，是否應(yīng)該立即送往醫(yī)院。

It is not an easy question to answer, experts say.

專家表示，這不是一個容易回答的問題。

“Every once in a while, even among healthy children, this influenza strain and others can make a person very, very sick, really fast,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine. “It’s deceptive.”

“偶爾，即使是在健康兒童當(dāng)中，這種流感毒株和其他毒株也能在很短的時間內(nèi)造成嚴(yán)重病情，”范德比爾特大學(xué)(Vanderbilt University)醫(yī)學(xué)院傳染病專家威廉·沙夫納(William Schaffner)博士說，“它很有欺騙性。”

Most parents know they need to closely monitor children under 5 for any signs their illness is getting more severe. It is important to pay even closer attention to babies and toddlers under 2, making sure they are getting enough liquids because they can easily become dehydrated.

大多數(shù)父母都知道，他們需要密切關(guān)注5歲以下的兒童，看他們是否出現(xiàn)任何病情惡化跡象。對于2歲以下的嬰兒和學(xué)步期兒童來說，需要更密切的關(guān)注，確保他們攝入足夠多的液體，因為他們很容易脫水。

And while the vast majority of otherwise healthy children will ride out a bout of influenza and recover rather quickly, a small number will develop potentially life-threatening complications that require immediate medical attention, Schaffner said.

沙夫納表示，雖然絕大多數(shù)健康的兒童能安然度過一場流感，快速康復(fù)，但一小部分兒童會出現(xiàn)可能危及生命的并發(fā)癥，需要立即就醫(yī)。

Children with chronic health conditions like asthma, diabetes, cystic fibrosis, cerebral palsy, heart conditions or seizures are also at increased risk for developing influenza-related complications, and the illness can exacerbate their underlying medical problems.

患有哮喘、糖尿病、囊性纖維化、腦癱、心臟病或癲癇等慢性疾病的兒童出現(xiàn)流感并發(fā)癥的風(fēng)險也在增加，而流感會加重他們的潛在健康問題。

But half of the children hospitalized with influenza this flu season did not have any of the underlying chronic conditions that make children susceptible to complications from influenza, according to the Centers for Disease Control and Prevention, and that is not unusual.

但據(jù)美國疾病控制和預(yù)防中心(Centers for Disease Control and Prevention)稱，在這個流感季因流感住院的兒童中，有半數(shù)沒有任何使他們?nèi)菀壮霈F(xiàn)流感并發(fā)癥的潛在慢性疾病，這并不罕見。

Signs to watch for in children are persistent high fevers that do not subside and fevers that abate only to flare up again after the child seems to be over the worst of the illness, experts say.

專家們表示，需要關(guān)注的跡象包括，毫不減退的持續(xù)高熱，或者，短暫退熱后，在孩子似乎已度過最嚴(yán)重階段后，再次發(fā)熱。

When that happens, time is of the essence; a persistent or recurrent fever may mean the child has developed a complication such as pneumonia or a dangerous inflammatory response, and parents must seek prompt medical attention.

這種情況發(fā)生時，最重要的是及時就醫(yī)。持續(xù)或反復(fù)發(fā)熱可能意味著，兒童出現(xiàn)了肺炎或危險的炎癥反應(yīng)等并發(fā)癥，父母必須立即送醫(yī)。

Parents should also be on the lookout for sepsis, a life-threatening complication caused by the body’s overwhelming attack against an infection. The condition is characterized by fever or chills, extreme pain or discomfort, clammy or sweaty skin, confusion or disorientation, shortness of breath and a high heart rate.

父母還應(yīng)該注意敗血癥，它是一種致命的并發(fā)癥，由身體對感染的過度攻擊導(dǎo)致。癥狀包括發(fā)熱或發(fā)冷，極度痛苦或不適，皮膚濕粘或出汗，意識混亂或迷失方向，呼吸短促，心跳加速。

“The trick with the flu is that it happens very quickly,” said Dr. Flor M. Munoz, associate professor of pediatrics and infectious diseases at Baylor College of Medicine in Houston. “You have to be really paying attention. Things can progress within 48 hours or so.”

“流感的棘手之處在于，它發(fā)展得很快，”休斯敦貝勒醫(yī)學(xué)院(Baylor College of Medicine)兒科和傳染病學(xué)副教授弗洛爾·M·蒙諾茲(Flor M. Munoz)說，“你必須非常注意。情況可能在48小時內(nèi)惡化。”

Symptoms that call for immediate medical care are if a child’s breathing becomes labored, and he or she is taking fast, shallow breaths or feels chest pain or pressure; if the child’s lips turn blue or purple; if he or she is less responsive than usual; if the child’s skin becomes clammy; or if the child refuses to eat or drink or has diarrhea and is vomiting, raising the risk of dehydration.

需要立即就醫(yī)的癥狀有：小孩呼吸出現(xiàn)困難或淺而急促，或呼吸時感到胸口疼痛或堵塞;小孩的嘴唇變藍(lán)或變紫;反應(yīng)不如往常;皮膚變得濕粘;或是拒絕進(jìn)食、喝水，出現(xiàn)腹瀉、嘔吐，脫水風(fēng)險增加。

In general, if a child is particularly irritable, is sleeping too much, seems confused, dizzy or not mentally alert, and not acting like his or her usual self, parents should seek medical help. Severe vomiting and seizures are also danger signs.

一般來說，如果小孩格外煩躁，睡眠過多，感到混亂、眩暈或遲鈍，與平時行為不同，父母都應(yīng)該尋求醫(yī)療幫助。嚴(yán)重的嘔吐和癲癇發(fā)作也是危險的征兆。

For children under 2, parents must be vigilant about making sure their child is getting enough fluids, and watch for urine that becomes dark in color, a sign of dehydration that calls for immediate medical care. Other symptoms to watch for in infants are trouble breathing, inability to eat, significantly fewer wet diapers than normal and crying without producing tears.

對于2歲以下的兒童，父母必須保持警惕，確保自己的孩子飲水夠量，要注意顏色較深的尿液是脫水跡象，需要立即進(jìn)行醫(yī)療護(hù)理。其他需要注意的癥狀有：呼吸困難、無法進(jìn)食、尿濕尿布數(shù)量與往常相比顯著減少，以及在哭泣的時候不流眼淚。

Ibuprofen or acetaminophen can be used in older children, but acetaminophen is the preferred drug for fever in infants. It should be used only in appropriate doses, as instructed on the package (aspirin should never be used in children).

布洛芬和撲熱息痛適用于年齡較大的兒童，但撲熱息痛是嬰兒發(fā)熱的首選藥物，應(yīng)按照包裝指示，依合適劑量服用(兒童絕不應(yīng)使用阿司匹林)。

“For a baby under 1, there’s a lower threshold to see the doctor,” Munoz said. “I would be willing to wait a little longer on a 12-year-old who can tell me how he feels, but for a baby that age, it’s hard for a parent to know what’s going on. You have to watch them very carefully and be attuned to changes.”

“對于1歲以下的嬰兒，看醫(yī)生的門檻應(yīng)該更低，”蒙諾茲說。“對于一個能告訴我他自己什么感受的12歲孩子，我會愿意再等久一些，但是對這個年紀(jì)的嬰兒，父母很難知道發(fā)生了什么。你要非常仔細(xì)的留意他們，也要了解并應(yīng)對變化。”

While it may not sound scientific, most experts say parents should trust their instincts. They know their children better than anyone else, and if they think something is wrong, they should call a doctor and ask for advice, or take the child to an urgent care center or emergency room.

雖然聽起來不太科學(xué)，但大多數(shù)專家表示，父母應(yīng)該相信自己的直覺。他們比其他人更了解自己的孩子，如果他們覺得有什么不對勁，就應(yīng)該尋求醫(yī)生的建議，或把孩子帶去緊急護(hù)理中心或急診室。

“When mom is really worried, that should not be trivialized — the pediatrician should look at that child closely,” Schaffner said.

“媽媽真正擔(dān)心的時候，就不應(yīng)該被輕視——兒科醫(yī)生應(yīng)給孩子仔細(xì)檢查，”沙夫納說。