儿童单纯性血尿27例临床分析

Clinical analysis of simple hematuria in 27 children

目的探讨儿童单纯性血尿的流行规律、临床特征、辅助检查、治疗及疗效。方法回顾性分析2014年1月至2019年11月本院单纯性血尿患儿的流行规律、临床特征、辅助检查、治疗及疗效。结果共纳入27例患儿,男20例,女7例;高发年龄为(4.99±2.53)岁;高发季节为冬季发病。临床特征:患儿均以肉眼血尿为首发表现,7例(25.93%)并发呼吸道感染,2例(7.41%)并发链球菌感染。辅助检查:多数患儿尿常规尿潜血、高倍镜下红细胞数增多,22.22%(6/27)的患儿合并白细胞数增高,11.11%(3/27)的患儿合并血沉增快;双肾、输尿管、膀胱彩超阳性率为18.52%(5/27),左肾静脉胡桃夹综合征超声检查阳性率为31.58%(6/19)。治疗及疗效:大部分患儿经抗感染、止血、清热解毒等对症支持治疗后,预后良好。结论单纯性血尿临床症状缺乏特异性,诊断较困难。影像学技术的提高,尤其是泌尿系统彩超,有助于辅助早期诊断。加强对单纯性血尿的认识及管理,掌握其流行规律、临床特征、实验室及影像学特点,以明确诊断,针对规范性用药。

Objective To explore the epidemic rule,clinical features,auxiliary examination,treatment,and curative effect of simple hematuria in children.Method The epidemic rule,clinical features,auxiliary examination,treatment,and curative effect of simple hematuria diagnosed in our hospital from January 2014 to November 2019 were analyzed retrospectively.Results A total of 27 children were enrolled,including 20 males and 7 females,with a high incidence age of(4.99±2.53)years old,mainly occurred in winter.Clinical features:hematuria was the main manifestation of the children;7 cases(25.93%)were complicated with respiratory infection and 2 cases(7.41%)were complicated with streptococcus infection.Auxiliary examination:there were urine occult blood and the number of red blood cells under high power microscope increased in routine urine test of most children,6 cases(22.22%)with leukocytosis and 3 cases(11.11%)with increased erythrocyte sedimentation rate;the positive rate of double kidney,ureter,and bladder color Doppler ultrasound was 18.52%(5/27),and the positive rate of ultrasonic examination of left renal vein nutcracker syndrome was 31.58%(6/19).Treatment and curative effect:most of the children had a good prognosis after anti-infection,hemostasis,heat-clearing and detoxifying and so on.Conclusions The clinical symptoms of simple hematuria are lack of specificity and the diagnosis is more difficult.The improvement of the imaging technique,especially the color Doppler of the urinary system,helps to assist in the early diagnosis.It helps to make clear diagnosis and can be used for normative medication to strengthen the understanding and management of simple hematuria,master its prevalence,clinical features,laboratory and imaging features.