结核专科384例发热门诊病例临床分析

Clinical analysis of 384 fever out-patients in tuberculosis department

目的了解结核专科医院发热病人的临床特点,做好各种呼吸道传染病的鉴别诊断。方法选取我院2004年1月～2007年12月收治的发热门诊病人384例,对其病因、流行病学史、伴随症状、血液分析、胸部X线表现及诊断情况进行分析。结果结核专科发热病人临床特点为:1、患者以16～40岁青壮年为主(61.46%);热度多为38～40℃的中高度热;2、病因以原有肺结核基础病或外院疑诊肺结核的占多数(73.96%);3、多数患者伴随咳嗽等呼吸道症状;4、胸片大多显示肺部不同部位、混合性病变;5、血液分析显示白细胞计数在正常至10×109/L以上为多。结论结核专科发热病人临床特点无特异性,发热门诊医生必须重点突出与传染性发热疾病的鉴别诊断。

Objective To understand the clinical characteristics of patients with fever in tuberculosis department, to make differentiated diagnose on different types of respiratory infectious diseases. Methods 384 patients with fever accepted to hospital from January 2004 to December 2007 were included in this study. Retrospective analyses were conducted on their pathogenesis, epidemiology, symptoms, blood analysis, chest X-ray film and the diagnosis. Results The clinical characteristics of the patients with fever in tuberculosis department were： 1. The patients were mainly young to middle age with a scope between 16 -40 years old （61.46%） ; the body temperature was 38- 40℃ as medium to high fever. 2. The pathogenesis of the patients was mainly pulmonary tuberculosis and suspected tuberculosis transmitted from other hospitals （73. 96% ）. 3. Most patients had accompanied symptoms of respiratory disease llke cough, expectoration, chest pain, gasping. 4. Most X-ray chest film indicates pathological changes in different areas and of different nature on the lung. 5. Blood analysis showed that in many cases the white cell count was from normal to above 10 × 10^9/L. Conclusion No specificity is found in the clinical characteristics of the patients with fever in tuberculosis department. The doctors for out patients with fever should pay special attention to differentiation and diagnosis of disease with fever, in particular the differentiation and diagnosis of infectious disease with fever.