肾盂输尿管连接处梗阻和膀胱输尿管连接处梗阻手术前后尿路感染情况分析  

Comparison of urinary tract infection before and after surgery for ureteropelvic junction obstruction and ureterovesical junction obstruction

作　　者：李培强[1] 黄岩[1] 张立华[1] 罗向阳[1] LI Pei-qiang;HUANG Yan;ZHANG Li-hua;LUO Xiang-yang(Department of Urology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第三附属医院泌尿外科,河南郑州450052

出　　处：《中华实用诊断与治疗杂志》2021年第8期826-827,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190383)。

摘　　要：目的分析经手术治疗的肾盂输尿管连接处梗阻(ureteropelvic junction obstruction,UPJO)和膀胱输尿管连接处梗阻(ureterovesical junction obstruction,UVJO)患儿的尿路感染情况,探讨不同梗阻部位尿路感染的可能原因。方法经手术治疗的上尿路梗阻患儿146例,其中UPJO患儿121例为UPJO组(行小切口离断式肾盂成型术),UVJO患儿25例为UVJO组(行开放输尿管膀胱再植术)。记录患儿手术前、后尿路感染发生情况,并进行2组间比较。结果UPJO组术前、术后尿路感染发生率(5.0%、9.1%)均低于UVJO组(52.0%、32.0%)(P<0.05),术前尿路感染持续时间[8(5,16)d]短于UVJO组[23(11,105)d](P<0.05),术后尿路感染持续时间[20(7,300)d]与UVJO组[75(22,165)d]比较差异无统计学意义(P>0.05)。结论上尿路梗阻患儿中UVJO并发尿路感染的风险较UPJO大,可能原因是梗阻使输尿管扩张导致感染风险增大。Objective To analyze the urinary tract infections in ureteropelvic junction obstruction(UPJO)and ureterovesical junction obstruction(UVJO)after surgery in children,and to investigate their possible causes.Methods In 146 children with upper urinary tract obstruction after surgery,121 children received small-incision pyeloplasty(UPJO group)and 25 children received open ureteral bladder replantation(UVJO group).The incidences of urinary tract infection before and after surgery were recorded,and were compared between two groups.Results The preoperative and postoperative urinary tract infection rates were lower in UPJO group(5.0%,9.1%)than those in UVJO group(52.0%,32.0%)(P<0.05).The duration of urinary tract infection was shorter in UPJO group(8(5,16)d)than that in UVJO group(23(11,105)d)before surgery(P<0.05),and showed no significant difference between UPJO group(20(7,300)d)and UVJO group(75(22,165)d)after surgery(P>0.05).Conclusion In children with upper urinary tract obstruction,the children with UVJO has a great risk of urinary tract infection than the children with UPJO.The possible cause is ureteral dilation.

关 键 词：肾盂输尿管连接处梗阻 膀胱输尿管连接处梗阻 尿路感染 肾积水 巨输尿管症 

分 类 号：R699.4[医药卫生—泌尿科学]