98例泌尿道感染患儿肾积水病因分析  

The etiological analysis of hydronephrosis with urinary tract infection in 98 children

作　　者：谷松磊 沈彤 杨晓庆 GU Songlei;SHEN Tong;YANGXiaoqing(Pediatric Department,Women and Children's Hospital,School of Medicine,Xiamen University,Xiamen 361003,Fujian,China)

机构地区：[1]厦门大学附属妇女儿童医院,厦门市妇幼保健院儿内科,福建厦门361003

出　　处：《临床儿科杂志》2021年第6期425-428,共4页Journal of Clinical Pediatrics

摘　　要：目的探讨泌尿道感染患儿肾积水的病因。方法回顾分析2010—2020年间98例因泌尿道感染住院行泌尿系彩超发现肾盂分离患儿的临床资料。结果98例泌尿道感染肾积水患儿基于泌尿道扩张分级系统进行分级:正常42例、1级17例、2级28例、3级11例。肾积水1、2和3级的患儿共合并泌尿系畸形36例(64.3%),发生率高于正常组(18例,42.9%),差异有统计学意义(χ^(2)=4.45,P=0.035)。肾积水存在的泌尿系畸形主要包括,肾盂输尿管连接处梗阻16例、膀胱输尿管反流16例及膀胱输尿管连接处狭窄8例等。肾盂输尿管连接处梗阻及膀胱输尿管连接处狭窄均以左侧为主,膀胱输尿管反流以双侧为主,差异有统计学意义(P<0.05)。不同肾积水分级组手术率差异有统计学意义(P<0.05),以3级组手术率为较高。泌尿道感染存在泌尿系畸形的手术率(29.63%)高于无泌尿系畸形的手术率(11.36%),差异有统计学意义(P<0.05)。结论肾积水病因常见为泌尿系畸形,其中以肾盂输尿管连接处梗阻及膀胱输尿管反流最常见,其次为膀胱输尿管连接处狭窄。肾积水分级及泌尿系畸形可考虑作为诊治的依据。Objective To explore the etiology of hydronephrosis with urinary tract infection in children.Methods The clinical data of 98 children hospitalized with urinary tract infection who were found to have renal pelvis separation by urinary tract color Doppler ultrasonography from 2010 to 2020 were retrospectively analyzed.Results Based on the urinary tract dilation grading system,hydronephrosis was graded in 98 children with urinary tract infection:normal in 42 cases,grade 1 in 17 cases,grade 2 in 28 cases and grade 3 in 11 cases.Thirty-six children(64.3%)with hydronephrosis grade 1,2 and 3 were complicated with urinary malformation,the incidence was higher than that in the normal group(18 cases,42.9%),and the difference was statistically significant(χ^(2)=4.45,P=0.035).The urinary malformations in hydronephrosis mainly included 16 cases of ureteropelvic junction obstruction,16 cases of vesicoureteral reflux and 8 cases of vesicoureteral junction stricture.The ureteropelvic junction obstruction and vesicoureteral junction stricture were mainly on the left side,while vesicoureteral reflux was mainly bilateral,and the difference was statistically significant(P>0.05).There was significant difference in operation rate among different grades of hydronephrosis(P<0.05),and the operation rate in the grade 3 group was higher.The operation rate of urinary tract infection with urinary system malformation(29.63%)was higher than that without urinary system malformation(11.36%),and the difference was statistically significant(P<0.05).Conclusion The common etiology of hydronephrosis is urinary malformation,among which the obstruction of the ureteropelvic junction and vesicoureteral reflux is the most common,followed by vesicoureteral junction stricture.The classification of hydronephrosis and urinary tract malformations can be considered as the basis for diagnosis and treatment.

关 键 词：肾积水 泌尿道感染 泌尿系畸形 

分 类 号：R726.9[医药卫生—儿科]