发热并白细胞计数正常或减少238例临床分析

目的总结发热查因并白细胞计数正常或减少患者的临床资料与特点,以指导临床诊治。方法回顾性分析2009年1月²013年12月间收治的238例发热查因并白细胞计数正常或减少患者的临床表现、相关辅助检查、诊断治疗经过等资料。结果 238例患者中以感染性疾病居首位占73.8%;其中尤以病毒性感染最多,占总人数的41.2%,占感染人数的58.7%;恶性肿瘤占7.2%;结缔组织疾病占2.5%;其它疾病占14.8%;原因不明占1.7%。结论此类患者经详细询问病史、查体和相应检查,大部分可确诊。病因仍以感染为主,但以病毒性感染居多,所以临床表现有其特殊性,应予关注。

CLINICAL ANALYSIS OF 238 CASES OF FEVER IN PATIENTS WITH NORMAL OR DE-CREASED WHITE BLOOD CELL COUNTS

Objective Analyzing and summarizing the characteristics and clinical data of 238 cases of unexplained fever in patients with normal or decreased white blood cell count, to guide the clinical diagnosis and treatment in feverish pa-tients with normal or decreased white blood cell count.Methods In the department of hematology 238 cases of fever in pa-tients with normal or decreased white blood counts have been collected from January 2009 to December 2013.Retrospectively analyze their clinical manifestations, related auxiliary examination, and diagnostic process and treatment.Results 234 cases in the total 238 cases had confirmed diagnoses, of which the rate was 98.3%.Of the total 238 cases, 176 cases （73.8%） were diagnosed with infectious diseases; 17 cases （7.2%） were diagnosed with malignancy; 6 cases （2.5%） were diag-nosed with connective tissue disease;35 cases （14.8%） were diagnosed with other diseases;diagnoses of 4 cases （1.7%） were not confirmed.Conclusion Most patients with fever can have a confirmed diagnosis after a detailed history and physical examination.The main cause of fever is infection.Fevers with normal or decreased white blood cell count have their particular clinical manifestations which should be concerned, targeted and treated accordingly as soon as possible.