【摘要】 目的　探讨成人恶性肿瘤患者中以不明原因发热 (FUO)为主要症状者的病因构成及诊断难点。方法　回顾性分析 1989年～ 2 0 0 2年以FUO入院、且最终诊断为恶性肿瘤的 48例成人患者的临床资料。结果　 48例患者中淋巴 /造血组织肿瘤 3 5例 ,占 72 .9% ,其中淋巴瘤 18例 ,恶性组织细胞病 13例 ;实体瘤 13例 ,占 2 7.1% ,其中 12例位于腹腔 ,7例为原发性肝癌。初诊与确诊相符者仅 5例 ,占 10 .4% ;有 3 9例被误诊为感染性疾病 ,占 90 .7% ,其中结核病最多。误诊的主要原因有 :( 1)症状和体症不典型 ;( 2 )入院初的影像学和活组织检查结果不支持 ;( 3 )使用肾上腺皮质激素和多种抗生素 ,一度掩盖病情。结论　警惕FUO病人中恶性肿瘤的可能性 ,尤其是淋巴瘤、恶性组织细胞病和腹腔实体瘤 ,尽量寻找诊断线索 ,同时合理使用退热药。更多还原

【Abstract】 Objective To evaluate the significance of mal ignant diseases in patients with fever of unknown origin(FUO).Methods The clinical data of 48 adult cancer patients presentin g as FUO were retrospectively reviewed,who were admitted to our university hospi tal from 1989 to 2002.Results The male-to-female ratio was 2.43:1.Their median feve r course was 56 days and median diagnostic time was was 13 days.Anemia was found in 89.6% and elevated erythrocyte sedimentation in 77.1% of the patients. Of 35 patients (72.9%) with hematological malignancies,most were lymphomas( n =18) and malignant histiocytosis( n =13).Solid tumors (almost in the abdomens) were found in 13 patients (27.1%), of which 7 were primary hepatic carcinomas.Only 5 patients got correct diagnosis at the beginning,and 39(90.7%) patients were m isdiagnosed for various infections.Inconclusive signs and symptoms,misinterpreta tion of test results,improper use of broad-spectrum antibiotics and corticostero id had all contributed to misdiagnoses.Conclusions It is necessary to be aware of the existence of mal ignancy in patients with FUO,especially those with anemia and elevated ESR.Antip yretic therapy should be performed properly.更多还原