104例儿童不明原因长期发热的临床分析

发布时间：2019-01-17 20:37

【摘要】：目的探讨儿童不明原因长期发热(FUO)的病因构成、诊断方法及预后,构建FUO标准化诊断流程。方法收集2005~2011年重庆医科大学附属儿童医院以"发热待查"收入院并符合FUO诊断标准的104例患儿的临床资料,按年龄分为3组:3岁组(47例),3~7岁组(24例)和7岁组(33例),进行回顾性分析,并对部分病例进行随访。结果确诊89例,确诊率为85.58%。位于前3位的病因在3岁组中为:感染性疾病(23例,48.93%),结缔组织疾病(5例,10.64%),肿瘤性疾病(1例,2.13%);3~7岁组中为:感染性疾病(11例,45.83%),恶性肿瘤性疾病(5例,20.83%),结缔组织疾病(4例,16.67%);7岁为:结缔组织疾病(19例,57.58%),感染性疾病(6例,18.18%),恶性肿瘤性疾病(2例,6.06%)。出院时痊愈24例(23.08%),好转60例(57.69%),未愈13例(12.50%),病情危重放弃治疗7例(6.73%)。随访61例,随访率58.65%,痊愈27例(44.26%),好转26例(42.62%),有严重并发症2例(3.28%),死亡6例(9.84%)。结论感染性疾病是婴幼儿FUO的主要病因,感染性疾病、结缔组织疾病和恶性肿瘤性疾病是学龄前期及学龄期儿童的主要病因。感染性疾病及结缔组织疾病预后较好,恶性肿瘤性疾病则预后差,死亡率高,但若能早期诊断,经规范治疗也可长期存活。
[Abstract]:Objective to investigate the etiology, diagnostic methods and prognosis of chronic fever (FUO) in children with unknown causes, and to establish a standardized diagnostic procedure for FUO. Methods the clinical data of 104 children who were admitted to Chongqing Medical University affiliated Children's Hospital from 2005 to 2011 and met the diagnostic criteria of FUO were divided into three groups according to their age: 3 years old group (47 cases). A retrospective analysis was made in 24 cases of 7 years old group and 33 cases of 7 years old group, and some cases were followed up. Results 89 cases were diagnosed and the diagnostic rate was 85.58%. The causes of the first three diseases were infectious disease (23 cases, 48.93%), connective tissue disease (5 cases, 10.64%) and tumor disease (1 case, 2.13%). In the group of 7 years of age, infectious disease (11 cases, 45.83%), malignant tumor disease (5 cases, 20.83%), connective tissue disease (4 cases, 16.67%); 7 years old: connective tissue disease (19 cases, 57.58%), infectious disease (6 cases, 18.18%), malignant tumor disease (2 cases, 6.06%). 24 cases (23.08%) were cured, 60 cases (57.69%) were improved, 13 cases (12.50%) were not recovered, and 7 cases (6.73%) gave up treatment in critical condition. 61 cases were followed up, the follow-up rate was 58.65%, 27 cases (44.26%) were cured, 26 cases (42.62%) improved, 2 cases (3.28%) had serious complications, 6 cases (9.84%) died. Conclusion Infectious disease is the main cause of FUO in infants. Infectious disease connective tissue disease and malignant tumor disease are the main causes of preschool and school-age children. The prognosis of infectious diseases and connective tissue diseases is better than that of malignant tumor diseases.
【作者单位】：重庆医科大学附属儿童医院感染科;
【分类号】：R72

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