Abstract: Background　The patients who are treated for medically unexplained physical symptoms（such as fatigue，etc.） account for a large proportion of the total patients visiting the general practice department of general hospitals in China. However，the characteristics and consultation reasons in patients with fatigue are rarely studied.Objective　To explore the characteristics and consultation reasons in outpatients with fatigue visiting the general practice department of the general hospital.Methods　Data（including sex，age，consultation time，initial reason for consultation，diagnosis，the first and subsequent consultations） were collected from the electronic medical record system of the First Affiliated Hospital，Zhejiang University，involving 301 eligible outpatients with fatigue seeking primary care between July 1，2017 and June 30，2018.Results　All the participants were from the general practice department，including 148 males（49.2%），and 153 females（50.8%），with an average age of（48.3±13.3） years old. The consultations peaked in summer（95 cases，31.6%） in 2018. Initial reason for consultation was fatigue（181 cases，60.1%）. The causes of fatigue could be identified initially in the general practice department in 26.2%（79/301） of the participants. And those〔25.3%（76/301）〕 whose causes of fatigue could not be identified were suggested to transferred to specialty departments，mostly to the mental health department〔39.5%（30/76）〕. Initial reason for consultation of fatigue was significantly associated with the classifications of consultation purpose and consultation outcome（P<0.05），while sex，age and consultation time were not（P>0.05）．Conclusion　Fatigue can be seen in any age，and at any time of a year in men and women. It can be an acute or a chronic health problem. As a general practitioner，it is necessary to grasp the correct assessment of fatigue and the identification of the cause，as well as the standardized follow-up of patients with chronic fatigue.

Key words: General practice；Outpatients；Hospitals, general；Fatigue；Medically unexplained physical symptoms

摘要： 背景　在国内综合性医院全科医学科因未分化疾病（如乏力等）就诊的患者占很大的比例，但针对乏力就诊患者的特点和病因等尚缺少相关的研究。目的　分析综合性医院全科门诊乏力患者特征及就诊原因。方法　选取2017-07-01至2018-06-30浙江大学医学院附属第一医院门诊电子病历系统中因乏力就诊患者301例为研究对象。收集患者的基本情况，包括性别、年龄、就诊时间、第一就诊原因、诊断；并对其当次及随后就诊记录进行分析，了解其乏力病因及最终去向。结果　301例患者因乏力就诊于全科门诊，其中男148例（49.2%），女153例（50.8%），平均年龄（48.3±13.3）岁。就诊时间上患者最多的是在2018年第二季度95例（31.6%），181例（60.1%）以乏力为第一就诊原因。26.2%（79/301）的患者可初步明确某系统疾病引起的乏力；25.3%（76/301）的患者建议其至专科进一步就诊明确病因，其中转诊最多的专科是精神卫生科〔39.5%（30/76）〕。不同性别、年龄、就诊时间患者就诊目的及去向分类比较，差异无统计学意义（P>0.05）；是否以乏力为第一就诊原因患者就诊目的及去向分类比较，差异有统计学意义（P<0.05）。结论　乏力可见于任一年龄、性别，也可见于任一时间段；既可为一种急性问题，也可为一种慢性健康问题。作为全科医师既要掌握乏力的正确评估和病因鉴别，也要对慢性乏力患者进行规范化的随访。

关键词: 全科医学, 门诊病人, 医院, 综合, 乏力, 未分化疾病