单中心5年先天性肾脏和尿路畸形住院构成分析  

Etiological analysis on inpatients with congenital anomalies of the kidney and urinary tract in a single centre in 5 years

作　　者：叶国嫦 高晓洁[1] 马颐姣[1] 贾实磊[1] 刘俐兵 Ye Guochang;Gao Xiaojie;Ma Yijiao;Jia Shilei;Liu Libing(Department of Nephrology,Shenzhen Children's Hospital,Shenzhen 518038,China)

机构地区：[1]深圳市儿童医院肾脏科,深圳518038

出　　处：《国际医药卫生导报》2023年第5期669-675,共7页International Medicine and Health Guidance News

基　　金：深圳市高水平医院建设专项经费资助项目(SZGSP012)。

摘　　要：目的分析儿童先天性肾脏和尿道畸形(CAKUT)诊断及首次入院原因,为CAKUT早期诊断及治疗提供依据。方法收集2015年1月至2019年12月深圳市儿童医院住院诊断为CAKUT临床资料,对其病种构成比及首次入院病因等信息进行回顾性分析。采用χ^(2)检验。结果1082例CAKUT患儿中,男702例、女380例。2015年至2019年CAKUT住院构成比逐年上升,由2015年的0.32%(152/47227)上升至2019年的0.44%(267/60280)(χ^(2)=11.22,P<0.05)。CAKUT住院构成比前4位病种分别为肾盂输尿管连接处梗阻(UPJO)、双集合系统、膀胱输尿管反流(VUR)和肾发育不良。首次入院因产前超声发现异常483例(44.6%),<1岁占75.4%(364/483);452例(41.8%)以泌尿系统症状和体征为首诊入院,≥1岁占65.0%(294/452);147例(13.6%)无相关症状,通过体检或因其他原因发现。1074例(99.3%)行超声检查,865例(79.9%)选择性进行了其他影像学检查。结论本中心CAKUT住院构成比呈逐年缓慢增长趋势,以UPJO、双集合系统、VUR和肾发育不良最为常见。产前和生后超声可作为CAKUT筛查的首选和主要手段。Objective To analyze the diagnosis and chief complaints of children with congenital anomalies of the kidney and urinary tract(CAKUT),in order to provide the clues for early diagnosis and treatment of CAKUT.Methods The clinical data of hospitalized CAKUT cases in Shenzhen Children's Hospital from January 2015 to December 2019 were reviewed.The diagnosis and chief complaints were retrospectively analyzed.χ^(2) test was used.Results A total of 1082 children with CAKUT were enrolled,including 702 boys and 380 girls.The proportion of hospitalized CAKUT cases was increased from 0.32%(152/47227)in 2015 to 0.44%(267/60280)in 2019(χ^(2)=11.22,P<0.05).The major CAKUT diseases included ureteropelvic junction obstruction(UPJO),duplex collecting system,vesicoureteric reflux(VUR),and renal dysplasia.A total of 483 cases(44.6%)were found with abnormalities by the prenatal ultrasound examination,among whom 75.4%(364/483)were younger than 1 year-old.A total of 452 cases(41.8%)showed urinary system symptoms,among whom 65.0%(294/452)were older than 1 year-old.A total of 147 cases(13.6%)had no clinical symptoms,and were found by physical examination or other reasons.Ultrasound examination was performed in 1074 CAKUT patients(99.3%);on the basis of ultrasound results and clinical manifestations,other examinations were performed in 865 cases(79.9%).Conclusions The proportion of CAKUT in our center shows a slow increasing trend year by year.UPJO,duplex collecting system,VUR,and renal dysplasia are the most common components of CAKUT.Prenatal and postnatal ultrasounography can be considered as the primary means of screening for CAKUT.

关 键 词：先天性肾脏和尿道畸形 肾盂输尿管连接处梗阻 膀胱输尿管反流 双集合系统 肾发育不良 首发症状 儿童 

分 类 号：R726.9[医药卫生—儿科]