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盗汗患者的诊治方法

Author
Gerald W Smetana, MD
Section Editor
Mark D Aronson, MD
Deputy Editor
H Nancy Sokol, MD

引言

在门诊初级保健中，盗汗是一种常见症状。虽然在直接采集病史后，一些病例的病因可能是明确的，但通常情况下，病因不会立即显现出来。在这些情况下，临床医生面临一个挑战，即要确定一个考虑周到、具有成本效益且全面的评估方案。

本文将讨论盗汗的定义、流行病学、鉴别诊断、病史采集和体格检查方法以及针对盗汗患者建议采取的评估方案。良性出汗过多(特发性多汗症)的处理将单独讨论。(参见“原发性局灶性多汗症”)

定义

盗汗必须与其他导致出汗的疾病相鉴别。鉴于本讨论的目的，故将盗汗定义为需更换床上用品的淋透性出汗。此较严格的定义排除了良性出汗增加或多汗症的患者。房间过热或太多的床上覆盖物可能是夜间出汗增加的直接原因。

尽管热潮红有数个显著特征，但其通常难以与盗汗相区别。热潮红的首发症状可能为胸部、乳房或腹部不适。随后突然感觉温热，继之出现胸部、头部和颈部可见的皮肤发红，观察者可明显发现这些变化[1]。温热持续3-4分钟，随后这些区域开始出汗，而(参见“绝经期潮热”)

潮红(类癌的一个特征和某些药物的不良反应)为面部(偶尔为躯干)的温热及发红。在实践中，很难将盗汗与潮红或出汗增加区分开来。因此，下文将讨论与所有这些症状相关的疾病。

                                

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Literature review current through: 2017-06 . | This topic last updated: 2015-06-19.
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