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3个月至2岁儿童尿路感染判断中的个人史与体格检查

Personal History and Physical Examination in Judgment of Urinary Tract Infection in Children Aged 3 Months to 2 Years.

作者信息

Wang Po-Yu, Chang Hui-Chin, Lei Ruoh-Lih, Kao Jun-Kai, Wu Chih-Lung, Lee Cheng-Han, Tseng Yu-Ching, Lin Long-Yau, Lee Ming-Sheng

机构信息

Department of Pediatric Emergency, Changhua Christian Children Hospital, Taiwan, ROC.

School of Public Health, Chung Shan Medical University, Taiwan, ROC.

出版信息

Pediatr Neonatol. 2016 Aug;57(4):274-9. doi: 10.1016/j.pedneo.2015.09.011. Epub 2016 Jan 28.

Abstract

BACKGROUND

Pediatricians ubiquitously rely on urine analysis for diagnosing urinary tract infection (UTI) in young febrile children due to discrepancies in symptom presentation. This study aimed to identify the determinants of physical examination and personal history for diagnosing UTI.

METHODS

Four hundred and ten patients aged between 3 months and 2 years presenting with a tympanic temperature of >38°C for >24 hours were requested to undergo urinary tests. Pediatricians completed patient record charts before the test results were generated, examined the final results of the tests, and compared the results with those reported in the medical records. Multivariate logistic regression analysis was performed to detect potential confounding factors.

RESULTS

An age of <1 year [odds ratio (OR): 5.05; p < 0.01], female sex (OR: 2.117; p < 0.05), and the absence of throat redness (OR: 1.907; p < 0.05) were risk factors for UTI. Patients defecating ≤3 times/day (OR: 8.80; p < 0.05) were more likely to have pyuria than those who defecated >3 times/day.

CONCLUSION

For febrile patients in the age group examined, the absence of throat redness and female sex were independent predictors of UTI. Moreover, the risk of UTI was higher in younger patients.

摘要

背景

由于症状表现存在差异,儿科医生在诊断幼儿发热性尿路感染(UTI)时普遍依赖尿液分析。本研究旨在确定用于诊断UTI的体格检查和个人病史的决定因素。

方法

要求410名年龄在3个月至2岁之间、体温>38°C超过24小时的患者进行尿液检查。儿科医生在测试结果出来之前填写患者记录图表,检查测试的最终结果,并将结果与病历中报告的结果进行比较。进行多因素逻辑回归分析以检测潜在的混杂因素。

结果

年龄<1岁(比值比[OR]:5.05;p<0.01)、女性(OR:2.117;p<0.05)以及无咽喉红肿(OR:1.907;p<0.05)是UTI的危险因素。每天排便≤3次的患者(OR:8.80;p<0.05)比每天排便>3次的患者更易出现脓尿。

结论

对于所研究年龄组的发热患者,无咽喉红肿和女性是UTI的独立预测因素。此外,年龄较小的患者患UTI的风险更高。

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