婴幼儿尿路感染61例影像学分析  

Imaging examination of 61 young children with urinary tract infection

作　　者：赵丽萍[1] 周红霞[1] 葛婷婷[1] 张林[1] 吴峤薇 梅柏如[1] 

机构地区：[1]无锡市儿童医院肾脏风湿免疫科,江苏无锡214023

出　　处：《临床儿科杂志》2011年第6期580-582,共3页Journal of Clinical Pediatrics

摘　　要：目的观察影像学检查在婴幼儿尿路感染诊断、治疗中的作用。方法回顾性分析2008—2009年61例婴幼儿尿路感染的影像学检查,2008年尿路感染患儿21例,所有患儿完成尿路超声检查,其中23.8%行肾静态显像(DMSA)筛查,9.5%行排尿性膀胱尿道造影(MCU)检查;2009年尿路感染患儿40例,所有患儿均完成尿路超声、DMSA筛查,72.5%行MCU检查。结果 2008年未发现膀胱输尿管反流(VUR)患儿,不排除有漏诊可能;2009年发现VUR14例,其中Ⅱ级反流2支,Ⅲ级反流4支,Ⅳ级反流9支,Ⅴ级反流6支,以高级别反流为主,无Ⅰ级反流。结论婴幼儿尿路感染的影像学检查,尿路超声仍应作为首选,DMSA应予常规检查,DMSA异常患儿行MCU检查,以早期诊断VUR给予合适的治疗而减少肾损伤发生。Objective To explore the role of the imaging examination in the diagnosis and treatment of the urinary tract infection, a common infectious disease, in infants and young children. Methods The results of imaging examination were retrospectively reviewed in 61 cases with the urinary tract infection during 2008 and 2009. All 21 cases enrolled in 2008 had taken the ultrasound examination, 23.8% of them had further received the examination of the dimercaptosuccinic acid scan （DMSA）, and 9% of them had received the examination of micturating cystourethrography （MCU）. All 40 cases enrolled in 2009 had taken both of the ultrasound examination and DMSA, 72.5% of them had further taken MCU. Results Vesicoureteral Reflux （VUR） was not found in all patients in 2008, however, there would be the possibility of the missed diagnosis. Fourteen cases were diagnosed as VUR in 2009, including grade I without branch, grade II with two branches, gradeⅢ with four branches, grade IV with nine branches and grade V with six branches, respectively. High-grade VUR was predominant in all the cases. Conclusions It is necessary to undertake imaging examination for the diagnosis of the urinary tract infection in infants and young children. The ultrasound examination is the most preferable method, and DMSA may be considered as the routine examination. A further evaluation with MCU can be performed on cases with positive findings of DMSA, so that the early diagnosis of VUR and the appropriate treatment can be given for reducing the risk of kidney injury.

关 键 词：尿路感染 影像学检查 膀胱输尿管反流 婴幼儿 

分 类 号：R726.9[医药卫生—儿科]