高龄患者发热待查的临床诊治体会

Experience of the diagnosis and treatment for fever in the senior patients

目的分析高龄患者发热的病因、临床特点。方法收集2006年1月-2008年12月我院干部病区收住的以发热为主要症状,年龄均在75岁～94岁的85例患者,进行回顾性分析。结果85例患者中,感染性疾病52例(61.1%),自身免疫性疾病4例(4%),恶性肿瘤20例(23.5%),其他疾病1例(1%),药物热2例(2%),不明原因6例(7%)。合并有心、肺、脑及肾等基础疾病的62例。结论高龄患者感染性疾病仍为发热的主要病因,也应警惕肿瘤的发生。多个基础疾病,对外界反应力和代偿力下降,独居老人病史提供欠准确,医师的临床处理水平及实验室条件,入院前使用药物干扰症状均导致诊断困难。详细询问病史及查体,有针对性的实验室检查有助于查明病因,尽早进行有效治疗。

Objective To analyze the etiology and the clinical characteristic of fever in senior patients. Methods 85 cases of fever patients were admitted to Shanxi Provincial Peopie＇s Hospital from January 2006 to December 2008. All patients were more than 75 yeas old. Results 52 of 85 cases had infectious disease, 4% had vascular diseases, 23.5% had neoplasms, and 1% had miscellaneous diseases, 6 patients could not be found fever causes. 62 patients combined with other diseases. Conclusion Infectious disease still remains a major cause of the fever in the oldest patients, but we should pay attention to the neoplasms in the senior patients. Athorough the senior patients had multiple diseases and they were weak for reaction and compensation, some old patients living alone could not told the history of disease exactly, full physical examination of the patient and laboratory studies were very important in finding the cause of the fever and the treatment to the patients early.