58例急诊发热原因待查患者临床及社会特征分析  

Clinical and social analysis of emergency patients with fever of unknown origin

作　　者：赵晓静[1] 佘君[1] 李萍[1] 白小燕[1] 毕晓菊 李丽君[1] 

机构地区：[1]西安交通大学医学院第二附属医院急诊科,西安710004

出　　处：《临床急诊杂志》2014年第3期135-137,共3页Journal of Clinical Emergency

摘　　要：目的：分析急诊发热原因待查患者临床及社会特征。方法：回顾性分析58例急诊发热原因待查住院患者一般情况、病因种类和临床检验。结果：①平均年龄（41±19）岁,分布以20~40岁居多;②在确诊的57例患者中感染性疾病占40例（70.2%）,其中脓毒症12例（30%）;非感染性疾病17例,其中风湿性疾病9例（52.9%）,分别为成人斯蒂尔病7例,系统性红斑狼疮1例,风湿热1例。恶性肿瘤4例（23.5%）。③在14项检验项目中,血培养不能姑息,骨髓及活组织检查及时实施。④平均住院费用为（1.6±2.3）万元。无要求转院患者,医疗纠纷发生5例。结论：急诊就诊发热原因患者中青年居多;感染性疾病比例高,其中首要排除脓毒症;非感染性疾病中成人斯蒂尔病多于结核病。多种临床检验依据病情尽早实施。应加强医患沟通交流,避免医疗纠纷发生。Objective：To summarize and analyze the clinical and social data of emergency patients with fever of unknown origin. Method： Medical records of 58 patients were reviewed by a retrospective analysis. Result： 57 cases were definitely diagnosed. OMean age was 41 ± 19 years old,and the highest age distribution was 20~40 years old. （2） There were 40 cases of infectious diseases （70.20/60 ）, and 12 cases of sepsis（30 % ）. 17 cases were diagnosed as non-infectious diseases with 9 cases of rheumatic diseases（52.9 %）,including 7 cases for adult onset still＇s dis- ease,1 case for Systemic Lupus Erythematosus and 1 case for rheumatic fever. There were 4 cases of malignant tumor. （3）Of the 14 items of examination, blood culture should be given as early as possible. Bone examination and tissue biopsy should be carried out as soon as possible. （4）The mean cost of hospitalization was （0. 016±0. 023） million Yuan for one patient without hospital referral requirement. There were five patients who had medical dis- putes throughout the whole hospitalization. Conclusion： Emergency patients with fever of unknown origin were mostly young. High proportion of infectious diseases was found in the study,and sepsis was the most common in- fectious diseases. Rheumatic diseases, especially adult onset still＇s disease, were the most common non-- infective diseases. Various clinical examinations should be combined to diagnosis of emergency fever with unknown origin.

关 键 词：发热 诊断 病因 临床检验 

分 类 号：R441.3[医药卫生—诊断学]