肾盂输尿管连接处狭窄患儿术后尿路感染的危险因素  

Risk factors of postoperative urinary tract infection in children with ureteropelvic junction obstruction after pyeloplasty

作　　者：柏凯平 张志远[1] 邢晓宇[1] 孙杰[1] BAI Kaiping;ZHANG Zhiyuan;XING Xiaoyu;SUN Jie(Department of Urology,Shanghai Children s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心泌尿外科,上海200127

出　　处：《现代泌尿外科杂志》2022年第1期16-19,29,共5页Journal of Modern Urology

基　　金：上海市科学技术委员会科研计划项目(No.19441914000)。

摘　　要：目的探讨肾盂输尿管连接部梗阻(UPJO)患儿术后出现尿路感染的相关危险因素。方法62例小于7岁的UPJO患儿中术后出现尿路感染者23例(尿路感染组)、未出现尿路感染者39例(无尿路感染组),比较两组患者手术前基本资料[年龄、性别、体质指数(BMI)]、磁共振泌尿系统显像(MRU)定量肾体积参数、肾盂前后径(APD)、美国胎儿泌尿外科学会(SFU)分级以及肾动态显像等指标,分析其与术后发生尿路感染的关联性。结果单因素分析显示,肾积水体积(P=0.037)和肾积水体积/肾体积(P=0.007)与术后尿路感染有关,同时也发现年龄和BMI是术后尿路感染的危险因素,进一步在调整了患者年龄与BMI后发现,仅肾积水体积/肾体积与术后感染的关联具有统计学意义(OR=1.039,95%CI:1.006~1.072,P<0.05)。结论MRU定量肾脏肾积水体积对UPJO术后早期尿路感染的诊断有明显价值,也可为及时、准确、合理地使用抗菌药物进行干预提供可靠依据。Objective To investigate the risk factors of postoperative urinary tract infection in patients with ureteropelvic junction obstruction(UPJO).Methods A total of 62 UPJO patients under 7 years were enrolled and divided into 2 groups according to the occurrence of postoperative urinary tract infection.Of the 62 children,23 developed postoperative urinary tract infection,while 39 did not.The preoperative data were compared,including age,sex,body mass index(BMI),magnetic resonance urography(MRU)quantitative renal volume parameters,anteroposterior diameter(APD),Society for Fetal Urology(SFU)grade,and renal dynamic imaging indexes.The relationship between these indexes and the occurrence of urinary tract infection was analyzed.Results Univariate analysis showed that hydronephrosis volume(P=0.037)and hydronephrosis volume/renal volume(P=0.007)were associated with postoperative urinary tract infection;age and BMI were risk factors.After patients age and BMI were adjusted,hydronephrosis volume/renal volume was found to be associated with the occurrence of urinary tract infection(OR=1.039,95%CI:1.006-1.072,P<0.05).Conclusion MRU quantification of renal hydronephrosis volume is significant for the diagnosis of early urinary tract infection in UPJO patients after operation,and it also provides reliable references for timely,accurate and reasonable use of antibiotics.

关 键 词：术后尿路感染 影像学体积 肾积水体积 肾盂输尿管连接处狭窄 儿童 体质指数 

分 类 号：R69[医药卫生—泌尿科学]