儿童泌尿道感染38例临床分析

Clinical analysis of 38 children with urinary tract infection

目的探讨儿童泌尿道感染的流行规律、临床特征、辅助检查、治疗和疗效。方法回顾性分析2021年1月至12月滨州医学院附属医院儿科儿童泌尿道感染的流行规律、临床特征、辅助检查、治疗和疗效。结果共纳入38例患儿,男18例,女20例;平均年龄3.7岁;全年均可发病。临床特征:多数患儿以尿路刺激症状、发热及血尿为主,少数存在恶心、呕吐,腹痛、腹泻等。其中有4例(10.5%)患儿合并呼吸道感染。辅助检查:27例(71.1%)患儿存在血常规白细胞计数升高,18例(47.4%)患儿降钙素原及C反应蛋白炎症指标升高;尿常规检查示:高倍镜下白细胞计数>5个/HPF有34例(89.5%),高倍镜下红细胞计数>3个/HPF有24例(63.2%),蛋白+有25例(65.8%);尿液培养阳性26例(68.4%);双肾、输尿管、膀胱彩超检查异常16例(42.1%)。治疗及疗效:多数患儿经抗感染、碱化尿液等对症支持治疗后,预后良好。结论儿童泌尿道感染多具有年龄特征,症状多不典型,大肠埃希菌感染占绝大多数,需结合尿沉渣分析、尿细菌学检查及影像学诊断,经正规抗感染治疗后,绝大多数患儿能治愈。

Objective To investigate the prevalence,clinical characteristics,auxiliary examination,treatment,and efficacy of urinary tract infection in children.Method The prevalence,clinical characteristics,auxiliary examination,treatment,and efficacy of pediatric urinary tract infection in Binzhou Medical University Hospital from January to December 2021 were retrospectively analyzed.Results A total of 38 children were included,including 18 males and 20 females;the average age was 3.7 years old;the disease could occur all year round.Clinical characteristics:most of the children had urinary tract irritation,fever,and hematuria,and a few had nausea and vomiting,abdominal pain,and diarrhea.There were 4 cases(10.5%)complicated with respiratory tract infection.Auxiliary examination:27 cases(71.1%)had elevated white blood cell count in blood routine,and 18 cases(47.4%)had elevated inflammatory indicators of procalcitonin and C-reactive protein.Routine urine examination showed that 34 cases(89.5%)had white blood cell count>5/HPF at high magnification,24 cases(63.2%)had red blood cell count>3/HPF,and 25 cases(65.8%)had protein+.The positive rate of urine culture was 68.4%(26/38).The positive rate of double kidney,ureter,and bladder color Doppler ultrasound was 42.1%(16/38).Treatment and efficacy:most of the children had a good prognosis after symptomatic supportive treatment such as anti-infection and alkaline urine.Conclusions Most pediatric urinary tract infections have age characteristics,and most of the symptoms are atypical.Escherichia coli infection accounts for the vast majority,which needs to be combined with urine sediment analysis,urine bacteriological examination,and imaging diagnosis.After formal anti-infection treatment,the vast majority of children can be cured.