Zelikovic I, Adelman R D, Nancarrow P A
Department of Pediatrics, University of Washington School of Medicine, Seattle.
West J Med. 1992 Nov;157(5):554-61.
Urinary tract infection is a common and frequently recurring condition in children. The susceptibility of the host, the presence of urinary tract abnormalities, and the virulence of the urinary pathogens are of primary importance in the development of the infection. Renal parenchymal scarring, hypertension, and renal insufficiency are well-established complications of the infection in children. To reduce the risk of renal damage, diagnosis and treatment must be prompt. The diagnosis demands radiologic evaluation of the urinary tract in all boys, all children younger than 5 years, all patients with voiding dysfunction, and school-aged girls with recurrent infection to identify those patients with vesicoureteral reflux, obstruction, or other urinary tract abnormalities. Both voiding cystourethrography and renal ultrasonography are the initial examinations to use to determine the next appropriate study. Children with vesicoureteral reflux or with recurrent urinary tract infections should receive prophylactic antibiotic therapy and should be observed closely to prevent renal scarring.
尿路感染是儿童常见且易复发的病症。宿主的易感性、尿路异常的存在以及尿路病原体的毒力在感染的发生发展中至关重要。肾实质瘢痕形成、高血压和肾功能不全是儿童感染的公认并发症。为降低肾损伤风险，诊断和治疗必须及时。对于所有男孩、所有5岁以下儿童、所有存在排尿功能障碍的患者以及反复感染的学龄期女孩，诊断需要对尿路进行放射学评估，以识别那些存在膀胱输尿管反流、梗阻或其他尿路异常的患者。排尿性膀胱尿道造影和肾脏超声检查都是用于确定下一步合适检查的初始检查方法。患有膀胱输尿管反流或反复尿路感染的儿童应接受预防性抗生素治疗，并应密切观察以预防肾瘢痕形成。
