60例急诊发热原因待查患者的临床和社会特征分析

The characteristics of clinical and social of 60 cases with fever of unknown origin in emergency department

目的探讨急诊发热原因待查（FUO）患者的临床和社会特征。方法选取2013年3月至2014年3月本院急诊科收治的60例FUO患者作为研究对象，分析患者的一般情况、发热病因和临床检验结果。结果入组60例患者年龄20-40岁最多，占42．4％，平均年龄为（40．43±15．47）岁；男性和女性平均年龄比较差异无统计学意义（t=-1．309，P〉0．05）；平均住院费用为0．8～1．6万元。本研究无要求转院患者，发生医疗纠纷患者3例。有594Y0患者获得确诊，其中感染性疾病41例，占69．5％；非感染性疾病18例，占30．5％。结论急诊FUO患者中以中青年居多；发热原因以感染性疾病最常见，其中首先要排除脓毒症；在非感染性疾病中以成人斯蒂尔病最常见；应根据病情尽早进行临床检查检验；加强医患沟通，避免医疗纠纷的发生。

Objective To investigate the characteristics of clinical and social of patients with fever of unknown origin in Emergency Department. Methods Total of 60 patients with fever of unknown origin in Emergency Department of our hospital from March 2013 to March 2014 were collected. The patient＇s general condition, fever etiology and clinical test results were investigation and analysis, respectively. Results The average age of the 60 cases was （40.43 ± 15.47） years, mainly distributed in 20-40 years. The average age of the men and women had no significant difference （t =- 1.309, P 〉 1.309）. The average hospitalization expenses of the 60 cases was 8-16 thousand yuan. There was no patients required to transfer to another hospital, while there were 3 cases had medical disputes. Total of 59 cases received a definite diagnosis, among whom, there were 41 cases with infectious diseases, accounted for 69.5% and 18 cases with non-infectious diseases, accounting for 30.5%. Conclusions The majority patients with fever of unknown origin in emergency department was young and middle-aged. The infectious diseases woere the most common reason, must first rule out sepsis. The adult Still disease was the most common reason in the non-infectious diseases. The clinical and laboratory examination should be done as soon as possible according to the condition. The doctor-patient communication should be strenghened, in order to avoid the occurrence of medical disputes.