王小洁　谭志容　莫信　郑玥　王志伟　张宏　鞠红艳

摘要 目的 通过与往年同时期的对比分析，观察新型冠状病毒肺炎（COVID-19）疫情期间非疫区基层发热门诊的病例特征。方法 以本院2019年1月19日—3月21日和2020年同期发热门诊就诊患者为研究对象，通过病历系统对患者年龄、性别、检查结果及疾病谱进行统计分析。结果 两年同期发热门诊患者男性多于女性，21～40岁的青壮年为主要人群。2019年患者中血常规阳性率73.84%，C反应蛋白（CRP）阳性率41.37%，肺部CT阳性率59.5%，2020年同期分别为65.61%、21.8%和74.12%，三组数据比较差异均有统计学意义（P<0.05）。所有诊断中2019年以急性上呼吸道感染最多，2020年以新型冠状病毒检测最多，占比41.23%;单纯“发热、咳嗽”占比16.73%和6.78%;感染性疾病占22.29%。结论 发热门诊在COVID-19疫情期间工作量明显增大，感染性疾病谱同2019年，但如对就诊患者更加科学疏导，可更有效利用医疗资源。

关键词 基层医院;发热门诊;临床资料;新型冠状病毒肺炎

中图分类号  R47    文献标识码  A    文章编号  1671-0223（2020）10-001-04

ANALYSIS ON THE CHARACTERISTICS OF FEVER OUTPATIENTS IN NON-EPIDEMIC AREAS DURING THE COVID-19 OUTBREAKS Wang Xiaojie，Tan Zhirong，Mo Xin，et al. Department of Neurology， Shekou Hospital， Nanshan， Shenzhen 518067，China

Abstract  Objective To observe the characteristics of fever outpatients in non-epidemic areas during the covid-19 outbreaks by comparing with the same period in previous years.Methods The age，gender，examination results and disease spectrum of the patients were statistically analyzed through the medical record system.Results In The same period of two years， male outpatients with fever were more than female patients，and young adults aged 21-40 were the main group.In 2019， the blood routine positive rate，C-reactive protein positive rate and lung CT positive rate of patients were 73.84%， 41.37% and 59.5%，respectively.In the same period of 2020， the rates were 65.61%， 21.8% and 74.12%，respectively.The data of the three groups showed statistical differences.The spectrum of infectious diseases was more consistent at two years.In 2019， acute upper respiratory tract infection was the most common diagnosis，and in 2020， novel coronavirus test was the most common diagnosis，accounting for 41.23%.Fever and cough alone accounted for 16.73% and 6.78% respectively.Infectious diseases accounted for 22.29 percent.Conclusion The workload of fever clinics increased significantly during the covid-19 outbreak，and the spectrum of infectious diseases was the same as that in 2019. However，more scientific counseling for patients would make more effective use of medical resources.

Key words  Primary hospital;Fever clinic;Clinical data;COVID-19

发热门诊是医院内防控急性传染病的第一道防线，是医院常年设立的门诊。2020年新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）疫情期间，非疫区发热患者有何特征变化，这些变化对疫情判断和控制有何关联，是我们基层医院所关心的问题。为此本文选取本院发热门诊2019年同期资料为对照，对比分析COVID-19疫情期间发热门诊接诊患者的特征。

1 资料及方法

1.1 资料来源

以2019年1月19日—3月21日和2020年同期到我院发热门诊就诊的患者为分析对象。分析资料来自医院电子病历信息系统。本院为广东省三級医院，有开放床位500余张，地处深圳市南山区，属非疫区的基层公立医院。

1.2 统计学分析

应用SPSS20.0软件系统进行数据统计分析，计数资料计算百分比，组间比较采用χ2检验，P<0.05为差异有统计学意义。

2 结果

2.1 发热患者一般资料

2020年1月19日—3月21日发热门诊挂号患者总计7771人次，年龄0～88岁，其中男性4110例，女性3661例。……