Lellig E, Apfelbeck M, Straub J, Karl A, Tritschler S, Stief C G, Riccabona M
Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
Urologe A. 2017 Feb;56(2):247-262. doi: 10.1007/s00120-016-0316-x.
Urinary tract infections (UTI) are the most common bacterial infections in children. The symptoms are not very specific and range from abdominal pain, poor feeding to nocturnal urinary incontinence. The technique of collecting urine plays an important role for securing the diagnosis. The best way to obtain urine in non-toilet-trained children is catheterization or suprapubic bladder aspiration. In toilet-trained children midstream urine is an acceptable alternative after cleaning the foreskin or labia. In the case of an infection a prompt empirical antibiotic therapy is necessary to reduce the risk of parenchymal scarring of the kidneys. There are different approaches to diagnose vesicoureteral reflux in different countries. The commonly used standard approach in Germany is voiding cystourethrography. In the case of reflux dimercaptosuccinic acid (DMSA) scintigraphy should be performed additionally to exclude renal scarring (bottom-up approach).
尿路感染（UTI）是儿童最常见的细菌感染。其症状不太具有特异性，范围从腹痛、喂养不良到夜间尿失禁。尿液采集技术对确诊起着重要作用。对于未接受如厕训练的儿童，获取尿液的最佳方法是导尿或耻骨上膀胱穿刺抽吸。对于已接受如厕训练的儿童，清洁包皮或阴唇后，中段尿是一种可接受的替代方法。在发生感染的情况下，及时进行经验性抗生素治疗对于降低肾脏实质瘢痕形成的风险是必要的。不同国家诊断膀胱输尿管反流有不同的方法。德国常用的标准方法是排尿性膀胱尿道造影。对于反流情况，应额外进行二巯基丁二酸（DMSA）肾闪烁扫描以排除肾瘢痕形成（自下而上的方法）。
