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[中段尿与膀胱穿刺尿用于诊断孕妇尿路感染]

[Mid-stream versus bladder puncture urine in the diagnosis of urinary tract infection in pregnant patients].

作者信息

Retzke U, Waitz I, Loth M, Liebetrau B

机构信息

Frauenklinik, Abteilung Mikrobiologie, Bezirkskrankenhauses Suhl.

出版信息

Zentralbl Gynakol. 1988;110(24):1567-73.

PMID:3066065
Abstract

150 healthy women being pregnant in the 1st, 2nd and 3rd trimester were examined. From the same content of urinary bladder suprapubic puncture urine (BPU) and mid-stream urine (MSU) were collected. The results concerning microbiological and microscopical analysis of urine proofs were compared. For qualitative and quantitative germ analysis MSU is sufficiently clean enough. In 95.3 there is a good correspondence of the microbiological results of both proofs. Exceptionally in 4.7% the MSU-results were not confirmed by BPU. With respect to the findings in sediment there is no good correspondence of the results. In case of sterile bladder content the BPU sediment - findings are significantly more frequent normal and significantly more seldom abnormal than in MSU. The sediment findings in MSU are more frequent false positive than in BPU. In case of an infected bladder content there are no significant differences in the sediment findings of both techniques in taking urine proofs. The rate of normal sediment findings in case of an infected bladder content is unrealistic high: In MSU in 11% and in BPU in 26%. For microbiologic germ diagnosis MSU and BPU proofs are equivalent. But, for detection or for exclusion of urinary tract infections the sediment finding is poorly pathognomonic for a urinary tract infection. A normal sediment finding does not exclude the existance of an urinary tract infection. Therefore, in the system of prenatal care we should waive of the sediment finding as a guide for the diagnosis of urinary tract infections.

摘要

对150名处于孕早期、孕中期和孕晚期的健康孕妇进行了检查。从膀胱相同容量的耻骨上穿刺尿(BPU)和中段尿(MSU)中采集样本。对尿液样本的微生物学和显微镜分析结果进行了比较。对于定性和定量细菌分析,MSU足够清洁。两种样本的微生物学结果在95.3%的情况下具有良好的一致性。仅在4.7%的情况下,MSU结果未得到BPU的证实。关于沉淀物的检查结果,两者没有良好的一致性。在膀胱内容物无菌的情况下,BPU沉淀物的正常检查结果明显比MSU更频繁,异常结果明显更少。MSU沉淀物的检查结果假阳性比BPU更频繁。在膀胱内容物感染的情况下,两种采集尿液样本技术的沉淀物检查结果没有显著差异。在膀胱内容物感染的情况下,正常沉淀物检查结果的比例高得离谱:MSU中为11%,BPU中为26%。对于微生物学细菌诊断,MSU和BPU样本是等效的。但是,对于检测或排除尿路感染,沉淀物检查结果对尿路感染的诊断缺乏特异性。正常的沉淀物检查结果不能排除尿路感染的存在。因此,在产前护理体系中,我们应该放弃将沉淀物检查结果作为尿路感染诊断的指导依据。

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