【摘要】：背景疲勞是基層醫(yī)療中較為常見的患者主訴之一。雖然該疾病存在自我局限性,并且經(jīng)常與心理社會壓力相關(guān)聯(lián),但是對于其可能存在的嚴重病因和如何進行適當?shù)脑\斷處理,患者及他們的醫(yī)生經(jīng)常不能確定。本文對基層醫(yī)療中疲勞鑒別診斷的相關(guān)研究進行了系統(tǒng)綜述和薈萃分析。方法通過Medline、EMbase和會議摘要,檢索有關(guān)基層醫(yī)療視角下患者出現(xiàn)疲勞的研究。共納入26項研究。本文將作為疲勞病因的貧血、惡性腫瘤、嚴重器質(zhì)性疾病、抑郁癥和慢性疲勞綜合征(CFS)視為目前主訴進行分析。結(jié)果貧血患病率為2.8%〔95%CI(1.6%,4.8%)〕;惡性腫瘤患病率為0.6%〔95%CI(0.3%,1.3%)〕;嚴重器質(zhì)性疾病患病率為4.3%〔95%CI(2.7%,6.7%)〕;抑郁癥患病率為18.5%〔95%CI(16.2%,21.0%)〕。CFS不適宜采用合并法。無疲勞癥狀患者軀體疾病的患病率與主訴疲勞患者的患病率相同;而主訴疲勞患者的抑郁癥患病率高于無疲勞癥狀患者。結(jié)論嚴重的軀體疾病在主訴疲勞的患者中是罕見的,且由于其與無疲勞癥狀患者的患病率相似,所以二者間可能并不存在因果關(guān)系。只有在實驗室檢查中獲得具體研究結(jié)論的情況下,廣泛的調(diào)查才能夠得到保證。否則,注意力應(yīng)該集中在抑郁和心理社會問題上。
[Abstract]:Background fatigue is one of the most common complaints in primary care. Although the disease has self-limitations and is often associated with psycho-social stress, patients and their doctors are often uncertain as to the possible serious causes of the disease and how to properly diagnose and manage it. This paper makes a systematic review and meta-analysis on the related research of fatigue differential diagnosis in primary care. Methods through Medlinea EMbase and conference summary, we searched for the study of patient fatigue from the primary care perspective. A total of 26 studies were included. Anemia, malignant tumor, severe organic disease, depression and chronic fatigue syndrome (CFS) are regarded as the main cause of fatigue. Results the prevalence of anemia was 2.8% (95%CI: 1.6%,);: 0.6%) (95%CI (0.33%, 1.3%), the prevalence of serious organic diseases (95%CI) was 4.3% (95%CI (2.7%); depression was 18.5% (95%CI (16.2%) 21.0%). The prevalence rate of somatic diseases in patients with no fatigue symptoms was the same as that in patients with main complaints of fatigue, while the prevalence of depression in patients with major complaints of fatigue was higher than that in patients with no symptoms of fatigue. Conclusion severe somatic diseases are rare in patients who complain of fatigue, and there may not be a causal relationship between them because they are similar to those without fatigue symptoms. A broad investigation can only be ensured if specific findings are obtained in laboratory inspections. Otherwise, focus on depression and psychosocial problems.
【分類號】：R442.9

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