尿路感染146例

Urinary Tract Infection in 146 Children

目的加强儿童尿路感染(UTI)的规范诊治,以提高其诊断及治愈率。方法回顾性分析2008年1月-2009年12月146例UTI患儿的诊治过程。2008年诊治的患儿均完成尿路超声检查,18.5%(10例)患儿行放射性核素肾静态显像(DMSA)筛查,9.2%(5例)患儿行排尿性膀胱尿道造影(MCU)检查;2009年规范UTI诊治,患儿均完成尿路超声检查、DMSA筛查,43.4%(40例)患儿行MCU检查。结果 2008年因UTI住院的患儿54例。以发热为主诉8例(14.8%),<1岁患儿3例(5.5%),发现膀胱输尿管反流(VUR)2例;2009年因UTI住院患儿92例。以发热为主诉50例(54.3%),<1岁患儿23例(25.0%),发现VUR16例。18例VUR患儿中Ⅰ级反流0支、Ⅱ级反流2支、Ⅲ级反流5支、Ⅳ级反流12支、Ⅴ级反流6支,以高级别反流为主,1岁内VUR患儿13例(72.2%)。结论强调重视婴幼儿尿液检查和尿液培养;UTI患儿需合理选择影像学检查,DMSA筛查异常患儿应予MCU检查,以提高VUR的确诊率。

Objective To enhance the standardization of diagnosis and treatment of children＇s urinary tract infection（UTI） and improve the diagnosis and cure rate of UTI. Methods A retrospective analysis of 146 cases with UTI from Jan. 2008 to Dec. 2009 was conducted. A- mong all the cases in 2008 year,all the patients were performed urinary tract ultrasound scanning, 10 cases（ 18.5% ） were performed isotope scan dimercaptosuccinic acid（DMSA） , and 5 cases （9.2%） received micturating cystourethrography （MCU） examination. In 2009 year, all the patients were performed urinary tract ultrasound scanning and DMSA,and 40 cases（43.4% ） were done with MCU. Results In 2008 year,54 children were hospitalized because of UTI. Fourteen point eight percent（8 cases） of the patients were present fever as the chief complaint. Younger than 1 year old was 3 cases（5.5% ）. Vesicoureteral reflux（VUR） was present in 2 cases. Ninety - two children were hospital- ized for UTI in 2009. Fever was the chief complaint in 50 cases（54.3% ） of the patients. Younger than 1 year old was 23 cases（25.0% ）. VUR was present in 16 cases. Among those 18 VUR cases,VUR were demonstrated in 0,2,5,12,and 6 in grade I , 1/ , ]]I ,and 1V examina- tions, respectively. Younger than 1 year old was 13 cases （72.2%）. Conclusions More attention should be paid to the urinary examination and urine culture in children. Children with UTI should choose proper imaging examinations. For children with abnormal DMSA results, they shall perform MCU,thus improve the diagnosis rate of VUR.