以发热为首诊症状的恶性实体肿瘤39例分析  

The analysis of 39 malignant solid tumor with febrility as primary symptom

作　　者：李啸峰[1] 马琳[1] 路静[1] 龙小华[1] 廖素环[1] 高普均[2] 

机构地区：[1]中山大学附属第五医院,珠海519000 [2]吉林大学第一医院

出　　处：《中国实用医药》2013年第11期49-50,共2页China Practical Medicine

摘　　要：目的探讨恶性实体瘤患者中以发热为首诊症状的病因及诊断原则。方法回顾性分析2002年7月至2010年2月以发热入院、且最终诊断为恶性实体瘤的39例患者的临床资料。结果 39例患者中肝癌10例(25.6%),肺癌9例(23.1%),结直肠癌5例(12.8%),胃癌3例(7.7%),鼻咽癌3例(7.7%),肾癌3例(7.7%),卵巢癌2例(5.1%),胰腺癌2例(5.1%),腹膜恶性间皮瘤1例(2.6%),小肠平滑肌肉瘤1例(2.6%),通过影像学发现26例(66.7%)、内镜检查19例(48.7%)和手术探查3例(7.7%),所有均经病理确诊。结论警惕发热患者中恶性实体瘤的可能性,既要重视病史采集、查体和基本辅助检查,又要重视影像学和内镜技术的应用,尽量寻找诊断线索,以减少误诊率。Objective To investigate the cause of a disease and diagnose of malignant solid tumor with febrility as primary symptom. Methods Retrospective analysis 39 clinical data which admission in febrility and diagnose malignant solid tumor in July 2002 to February 2010. Results There are 10 hepatoma （25.6%）, 9 lung cancer （23.1%）, 5 colorectal cancer （12. 8% ）, 3 gastric cancer （7. 7% ）, 3 nasopharyngeal carcinoma （7.7%）, 3 renal carcinoma （7.7%） , 2 ovarian cancer （5. 1% ）, 2 pancreatic cancer （5.1%）, 1 abdominal membrane malignant mesothelioma （2. 6% ）, 1 small intestine leiomyosarcoma （2. 6% ）. 26 case were discovered by image imageology（66. 7% ） ,19 case by endoscopy （48.7%）and 3 case by operation research（7.7% ） . All case were diagnsed finaly in pathology. Conclusion Vigilance the possibility of malignant solid tumor in febrile patient, reconstruction history-taking, check and auxiliary examination, imageology and endoscopic technic. Search the clues to diagnose and decrease misdiagnosis rate.

关 键 词：发热 恶性肿瘤 诊断 误诊 

分 类 号：R730.5[医药卫生—肿瘤]