152例不明原因发热患者病因和诊断方法分析

Analysis of the Etiological Factor and the Diagnostic Methods of FUO

目的:分析不明原因发热(FUO)病因和诊断方法,避免误诊和漏诊。方法:选择152例符合FUO病例,对病因和确诊的最终诊断方法进行分析。结果:138例(91.8%)FUO患者通过血清学和(或)细菌学、体液或骨髓、组织活检、手术探查以及观察临床过程和(或)治疗反应获得明确诊断。感染性疾病组占48%(73/152),在感染组中,传染性疾病共27例,占17.8% (27/1 52),而结核病(肺结核、肺外结核)17例(17/152),占11.2%;肿瘤性疾病占27.6%(42/152),血管结缔组织病占15.1% (23/152),仍有9.2%(14/152)诊断不明。结论:感染性疾病、肿瘤性疾病、结缔组织-血管性疾病是我院FUO主要原因,在诊断FUO时,应尽可能获得病原学、免疫学、病理学依据,这样有助于避免误诊、漏诊和治疗的盲目性。

Objective: Analysis of the etiological factor and the diagnostic methods of FUO (Fever of unknown origin) in order to avoid misdiagnosis and missed diagnosis. Methods: We prospectively collected a series of 152 patients with FUO referred to our hospital between 1991. 5 and 2003. 5. Results: A final diagnosis was established in 138 patients (91. 8%), by using laboratory tests and diagnostic tools, such as aerology or/and bacteriology, body fluid, bone marrow, tissue biopsy, surgical exploration as well as observing clinical procedure or/and therapeutic response. However,there is still 14 (9.2%) undiagnosed cases. Among the 138 patients with a final diagnosis, infectious diseases represented the most prevalent diagnostic category (48% ). Contagious diseases made up 11. 5% (27/152) of FUO, and Tuberculosis ( Pulmonary tuberculosis and External tuberculosis) were responsible for 11.2% (17/152) of FUO; Neoplasm were responsible for 27.6% (42/152) of FUO, Connective tissue-Vascular diseases were responsible for 15.1% (23/152) of FUO. Conclusion: In our hospital, infectious diseases,Neoplasm,Connective tissue-Vascular diseases were responsible for main cause of FUO. In regards to FUO,to get the etiology,immunology and pathology diagnosis base to exhaust, Only in this way,can we avoid misdiagnosis, missed diagnosis and aimless treatment.