学龄期儿童不典型泌尿道感染的临床特点研究

发布时间：2019-03-05 17:33

【摘要】：目的探讨学龄期儿童不典型泌尿道感染(UTI)的临床特点,为及时确诊和改善患儿预后提供参考。方法选取2011—2016年在中国人民解放军第八一医院住院并确诊的UTI患儿81例。根据患儿是否存在UTI典型症状,将纳入患儿分为典型组和不典型组。通过查阅病历的方法,收集两组患儿的临床资料,包括性别、年龄、临床症状、辅助检查结果、并存病、诊断、治疗及预后。结果 81例患儿中,典型组45例(55.6%),不典型组36例(44.4%)。两组患儿性别、年龄比较,差异均无统计学意义(P0.05)。不典型UTI临床症状中,两组患儿腹痛、呕吐、外阴瘙痒、内裤上有异常分泌物发生率比较,差异均有统计学意义(P0.05);两组患儿发热发生率比较,差异无统计学意义(P0.05)。两组患儿入院时白细胞尿、血尿及蛋白尿发生率,白细胞计数、C反应蛋白、尿素氮及血肌酐水平比较,差异均无统计学意义(P0.05)。两组患儿尿细菌培养结果显示均以大肠埃希菌为主要致病菌,两组菌种总体分布比较,差异无统计学意义(P0.05);两组对头孢他啶、头孢曲松、哌拉西林钠他唑巴坦钠、氨曲南的敏感率比较,差异均无统计学意义(P0.05)。典型组被误诊的患儿例数为0例;不典型组最初被误诊的患儿例数为10例(27.8%),两组误诊率比较,差异有统计学意义(P0.05)。结论学龄期儿童不典型UTI临床上并不罕见,腹痛、呕吐、外阴瘙痒及内裤上有异常分泌物发生率及误诊率更高。临床医生应提高对不典型UTI临床特点的认识,减少误诊。
[Abstract]:Objective to investigate the clinical features of atypical urinary tract infection (UTI) in school-age children and to provide reference for timely diagnosis and improvement of prognosis. Methods from 2011 to 2016, 81 children with UTI who were hospitalized in the 81st Hospital of the Chinese people's Liberation Army (PLA) were selected. According to the typical symptoms of UTI, the patients were divided into two groups: typical group and atypical group. The clinical data, including sex, age, clinical symptoms, auxiliary examination results, concomitant diseases, diagnosis, treatment and prognosis, were collected by consulting the medical records of the two groups. Results of the 81 children, 45 (55.6%) were in the typical group and 36 (44.4%) in the atypical group. There was no significant difference in sex and age between the two groups (P0.05). In atypical UTI clinical symptoms, the incidence of abdominal pain, vomiting, vulvar pruritus and abnormal secretion in underwear between the two groups was statistically significant (P0.05). There was no significant difference in the incidence of fever between the two groups (P0.05). There was no significant difference in leucuria, hematuria and proteinuria, leukocyte count, C-reactive protein, urea nitrogen and serum creatinine between the two groups (P0.05). The results of urine bacterial culture in the two groups showed that Escherichia coli was the main pathogen, and there was no significant difference in the distribution of bacteria between the two groups (P0.05). The sensitivity rates of ceftazidime, ceftriaxone, piperacillin and tazobactam were not significantly different between the two groups (P0.05). The number of misdiagnosed children was 0 in typical group and 10 (27.8%) in atypical group. There was significant difference in misdiagnosis rate between the two groups (P0.05). Conclusion atypical UTI is not uncommon in school-age children, and the incidence of abdominal pain, vomiting, pruritus vulva and abnormal secretion on underpants is higher and misdiagnosis rate is higher. Clinicians should improve their understanding of the clinical characteristics of atypical UTI and reduce misdiagnosis.
【作者单位】：中国人民解放军第八一医院儿科;
【分类号】：R726.9

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