102例不明原因发热患者的病因分布及诊断策略研究

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1、授予单位代码10089学号或申请号20153170中国图书分类号R441.3HebeiMedicalUniversity硕士学位论文专业学位102例不明原因发热患者的病因分布及诊断策略研究研究生：贾伟华导师：郭丽萍教授专业：内科学二级学院：河北医科大学第二医院2018年3月河北医科大学目录中文摘要····························································································10英文摘要·················

2、············································································20英文缩写·····························································································40研究论文102例不明原因发热患者的病因分布及诊断策略研究前言·························································

3、·····································50材料与方法····················································································5结果·····························································································70附图····································

4、····················································90附表······························································································10讨论······························································································15结论············

5、·················································································18参考文献······················································································19综述不明原因发热诊断策略的研究进展··················································23致谢··················

6、···············································································34个人简历····························································································35中文摘要102例不明原因发热患者的病因分布及诊断策略研究摘要目的：研究不明原因发热（FUO）的病因分布及诊断策略。方法：制定FUO诊断策略，自2016年03月至2017年

7、10月前瞻性序贯纳入FUO患者，按照FUO诊断策略进行诊断，观察不同性别、年龄、热程、合并症FUO患者病因分布是否存在差异。评估该诊断策略的确诊率、平均确诊时间、平均住院花费等。结果：纳入FUO患者102例,感染性疾病60例，泌尿系感染居多，结缔组织病10例,血管炎居多，恶性肿瘤5例,淋巴瘤居多，其他疾病12例，坏死性淋巴结炎居多，未明确诊断15例，确诊87例，确诊率为85.3%，平均确诊时间为8.3天、平均住院花费1.49万元，依从诊断策略者90例，依从率为88.2%。不同性别、热程FUO患者的病因分布无明显差异；老年F

8、UO患者感染性疾病比例高于中青年（P<0.05），中青年FUO患者非感染性疾病的比例高于老年（P<0.05），无合并症FUO患者非感染性疾病的比例高于有合并症者（P<0.05）。结论：FUO最常见病因为感染性疾病，以泌尿系感染居多，其次为结缔组织病及恶性肿瘤。老年FUO患者感染性疾病更多见。中青年及无合