小儿泌尿系统感染与先天性泌尿系统畸形关系的临床分析  

Clinical analysis of relationship between urinary tract infection and congenital malformalities of urinary tract in children

作　　者：郑方芳[1] 刘晓红[2] 莫樱[2] 蒋小云[2] 宋洁[1] 周传新[1] 

机构地区：[1]中山大学附属第五医院,珠海519000 [2]中山大学附属第一医院儿科,广州510080

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第1期67-70,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：2015年广东省中医药局项目(20151161);2014年广东省科技计划项目(2014A020212140)~~

摘　　要：目的分析小儿泌尿系统感染(UTI)与先天性泌尿系统畸形的关系。方法选择2003年1月至2014年12月于中山大学附属第一医院和中山大学附属第五医院儿科住院的295例UTI患儿为研究对象,按照泌尿系统影像学检查结果将其分为畸形组(n=85,有先天性泌尿系统畸形)和无畸形组(n=210,无先天性泌尿系统畸形)。比较两组UTI患儿的临床特征,包括性别、发病年龄、有无发热、白细胞计数、红细胞沉降率、感染次数、肾功能异常及合并其他先天性畸形情况。本研究遵循的程序符合中山大学附属第一医院和中山大学附属第五医院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书。两组患儿UTI严重程度、住院时间比较,差异无统计学意义(P>0.05)。结果两组UTI患儿在性别、发病年龄≤30d、感染次数≥2次、合并其他先天性畸形方面比较,差异均有统计学意义(χ2=10.678、4.466、6.745、3.466,P<0.05)。畸形组患儿先天性泌尿系统畸形类型以膀胱输尿管返流为主(18.8%),其次为先天性肾积水(15.3%)和输尿管狭窄(11.8%)等。随访53例患儿中,10例(18.9%)接受手术治疗,其中,仅1例(1.89%)输尿管狭窄患儿于术后6个月复发UTI。结论小儿UTI与先天性泌尿系统畸形密切相关,反复UTI、合并其他先天性畸形、发病年龄≤30d的男性UTI患儿罹患先天性泌尿系统畸形的可能性较高。Objective To analyze the relationship between urinary tract infection（UTI）and congenital malformalities of urinary tract in children.Methods From January 2003 to December2014,a total of 295 children with UTI in the First and the Fifth Affiliated Hospital of Sun Yat-sen University were included in the study.They were divided into malformalities group（n=85,with congenital malformalities of urinary tract）and non-malformation group（n=210,without congenital malformalities）according to their imageological examination results.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of First Affiliated Hospital of Sun Yatsen University and Fifth Affiliated Hospital of Sun Yat-sen University.Informed consent was obtained from each participant′parents.The clinical features were compared between two groups,including gender,age,fever,white blood cell count,erythrocyte sedimentation rate,frequency of infection,abnormal renal function and combination with other congenital malformalities.There were no significant differences between two groups in UTI severity and hospital stay（P〈0.05）.Results There were significant differences in gender,age≤30days,frequency of infection（more than twice）and combination with other congenital malformalities（χ2=10.678,4.466,6.745,3.466;P〈0.05）.The main tpye of congenital urinary tract malformalities was vesicoureteral reflux（18.8%）,followed by congenital hydronephrosis（15.3%）and ureteral stricture（11.8%）,etc..Among 53follow-up cases in malformation group,10cases（18.9%）underwent surgery treatment,only 1case（1.89%）had recurrent UTI.Conclusions UTI and congenital urinary tract abnormalities are closely related in children.The children with UTI who are male,age≤30days,with repeated UTI and combination with other malformalities are remain on high alert for congenital malformalities of urinary tract.

关 键 词：泌尿系疾病 感染 泌尿生殖系统畸形 先天畸形 儿童 

分 类 号：R726.9[医药卫生—儿科]