147例急性附睾炎患者的尿液培养检查结果分析  

The value of the urine culture in 147 acute epididymitis

作　　者：钱晓辉[1] 黄河[1] 彭洪亮[1] 申隆江[1] 

机构地区：[1]长沙市第四医院泌尿外科,湖南410008

出　　处：《国际泌尿系统杂志》2015年第6期836-839,共4页International Journal of Urology and Nephrology

摘　　要：目的 急性附睾炎是儿童患者常见疾病之一.有报道认为由于尿液细菌培养检查结果常呈阴性,尿液检查对急性附睾炎的诊断和治疗参考价值存在质疑.在本研究中,我们对儿童附睾炎患者临床特征和尿液相关检查价值进行讨论.方法 在本研究中,回顾分析本院2012年1月至2014年12月147例急性附睾炎病例,入选患者是通过其临床症状、体格检查及阴囊彩超检查而确诊.为了研究儿童患者急性附睾炎的特点,在研究中将入选患者分为三组：A组：＜18岁,80例;B组：18 ～35岁,21例;C组：＞35岁,47例.结果 研究发现,各年龄组之间,在症状持续时间、住院天数及损害侧别,存在显著统计学差异.在老年组,白细胞计数、血清C反应蛋白水平、脓尿及尿培养阳性率有显著增高.而在儿童组,急性附睾炎主要的病因是原发性的（96.1％）.结论 在儿童组患者中80例中77例（96.3％）在尿液分析中尿分析脓尿为阴性.由于大多数尿液分析没有显示脓尿,故考虑其主要是原发性的.在儿童急性附睾炎患者常规使用抗生素治疗也许是不必要的.而对于尿液分析显示有脓尿,伴有或不伴有阳性尿培养结果的患者,则应考虑使用抗生素治疗。Objectives Acute epididymitis is one of the common diseases in children patients.Recent reports have shown that urinalysis is not helpful for the diagnosis and treatment of acute epididymitis owing to negative microbiological findings.Therefore,we analyzed clinical and laboratory characteristics to examine the diagnostic yield of urinalysis in children.Methods We retrospectively reviewed the medical records of 142 patients who were diagnosed with acute epididymitis from 2011 to 2013.Diagnosis was based on symptoms,physical findings,and color Doppler ultrasonography （DUS）.To investigate the characteristics of epididymitis in children,the patients were divided into 3 groups：group A （aged less than 18 years,76 patients）,group B （18 to 35 years old,19 patients）,and group C （older than 35 years,44 patients）.Results There were statistically significant differences in age,symptom duration,hospital stays,and lesion location in each group.White blood cell count and serum C-reactive protein levels,pyuria,and positive urine culture results were statistically higher in the older age group.The most common cause of acute epididymitis in children was idiopathic （96.1%）.Conclusions In our group of children with epididymitis,73 cases out of 76 （96.1%） resulted in negative pyuria in urinalysis.In addition,the most common cause of epididymitis is idiopathic.Because most urinalyses do not show pyuria,we believe that routine antibiotics may be not required in pediatric patients with epididymitis.If urinalysis shows pyuria with or without positive urine culture,antibiotics should be considered.

关 键 词：附睾炎 尿 

分 类 号：R697.22[医药卫生—泌尿科学]