114例小儿不明原因长期发热的临床分析

A clinical analysis on 114 cases of fever of unknown origin

目的:探讨不明原因长期发热(FUO)患儿的病因及诊断方法。方法:回顾性地总结分析符合FUO诊断标准的患儿114例。结果:114例中明确诊断有90例,确诊率为78.9%,未能确诊24例(21.1%)。病因:感染性疾病63例(70.0%),结缔组织病15例(16.7%),肿瘤及恶性疾病12例(13.3%)。最终确定诊断的方法分别为:血清学和(或)细菌学检查41例,占45.6%;组织活检3例,占3.3%;骨髓检查8例,占8.9%;影像学检查20例,占22.2%;临床过程和(或)治疗反应观察18例,占20.0%。结论:根据临床经过和必要的辅助检查可以明确FUO中的大多数病例的病因诊断;感染性疾病、结缔组织病及肿瘤性疾病是本组的主要病因。

Objective ： To investigate the causes and diagnostic methods of fever of unknown irigin（FUO）. Methods ： The clinical data of 114 patients with FUO were analyzed retrospectively. Results ：The definite diagnosis was finally made in 90 cases, the definite diagnostic rate being 78.9%, 24 cases（21.1% ） failed to be diagnosed. 63 definite cases（70.0% ） were caused by infectious diseases; 15 cases（ 16.7 % ） were caused by connective tissue diseases. 12 cases（ 13.3 % ） were due to tumors and malignant discases, a final diagnosis was made respectively by serology and（or） bacteriology（45.6% ） ; biopsy（3.3% ） ; bone marrow examination（8.9 % ） ; radiology（22.2% ）; clinical course and treatment（20.0%）. Conclusion：Most patients with FUO could be diagnosed according to the clinical course and necessary aided examination. Infectious diseases , connective tissue discases and tumor diseases were the main causes of FUO in the studied group.