【摘要】：目的探討學(xué)齡期兒童不典型泌尿道感染(UTI)的臨床特點,為及時確診和改善患兒預(yù)后提供參考。方法選取2011—2016年在中國人民解放軍第八一醫(yī)院住院并確診的UTI患兒81例。根據(jù)患兒是否存在UTI典型癥狀,將納入患兒分為典型組和不典型組。通過查閱病歷的方法,收集兩組患兒的臨床資料,包括性別、年齡、臨床癥狀、輔助檢查結(jié)果、并存病、診斷、治療及預(yù)后。結(jié)果 81例患兒中,典型組45例(55.6%),不典型組36例(44.4%)。兩組患兒性別、年齡比較,差異均無統(tǒng)計學(xué)意義(P0.05)。不典型UTI臨床癥狀中,兩組患兒腹痛、嘔吐、外陰瘙癢、內(nèi)褲上有異常分泌物發(fā)生率比較,差異均有統(tǒng)計學(xué)意義(P0.05);兩組患兒發(fā)熱發(fā)生率比較,差異無統(tǒng)計學(xué)意義(P0.05)。兩組患兒入院時白細(xì)胞尿、血尿及蛋白尿發(fā)生率,白細(xì)胞計數(shù)、C反應(yīng)蛋白、尿素氮及血肌酐水平比較,差異均無統(tǒng)計學(xué)意義(P0.05)。兩組患兒尿細(xì)菌培養(yǎng)結(jié)果顯示均以大腸埃希菌為主要致病菌,兩組菌種總體分布比較,差異無統(tǒng)計學(xué)意義(P0.05);兩組對頭孢他啶、頭孢曲松、哌拉西林鈉他唑巴坦鈉、氨曲南的敏感率比較,差異均無統(tǒng)計學(xué)意義(P0.05)。典型組被誤診的患兒例數(shù)為0例;不典型組最初被誤診的患兒例數(shù)為10例(27.8%),兩組誤診率比較,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論學(xué)齡期兒童不典型UTI臨床上并不罕見,腹痛、嘔吐、外陰瘙癢及內(nèi)褲上有異常分泌物發(fā)生率及誤診率更高。臨床醫(yī)生應(yīng)提高對不典型UTI臨床特點的認(rèn)識,減少誤診。
[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.
【作者單位】： 中國人民解放軍第八一醫(yī)院兒科;
【分類號】：R726.9

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