Ortega Enciso L, Sánchez Martínez F, Escape Díaz-Bonilla I, Martínez Montauti J, Bastart Miralles F, Vilà Santasuana A
Servicio de Medicina Interna, Hospital de Barcelona-SCIAS.
Rev Clin Esp. 1998 Oct;198(10):647-50.
Echography is a non-invasive procedure which detects abnormalities in kidney and/or urinary tract.
To determine whether the routine use of an echography in women with the diagnosis of acute pyelonephritis (APN) provides relevant findings to diagnosis and determines a change in therapy.
A total of 100 patients admitted to the hospital with the diagnosis of APN who had undergone an echography were studied. Seven clinical criteria were evaluated: persistent fever for longer than 72 hours after starting an appropriate antibiotic therapy, episodes of previous urinary tract infections, previous history of kidney stones, anatomic abnormalities in the urinary tract, colic pain, persistent hematuria, and pregnancy. On the basis of these criteria two groups were defined: a) indicated echography (IE), for patients fulfilling at least one the above criteria; b) non-indicated echography (NIE), for patients fulfilling none of the above criteria.
IE group was made up of 47 patients, with a normal echography in 18 (38%); the NIE group was made up of 53 women, with a normal echography in 51 of them (96%). The abnormal findings in echography led to a change in therapeutic behaviour in 11 patients in the IE group (23%) and in 2 patients in the NIE group (4%).
The routine use of abdominal echography in women with the diagnosis of APN is not indicated in absence of clinical data supporting the presence of a complicated APN.
超声检查是一种检测肾脏和/或尿路异常的非侵入性检查方法。
确定对诊断为急性肾盂肾炎（APN）的女性常规进行超声检查是否能为诊断提供相关结果并确定治疗方案的改变。
对100例诊断为APN且已接受超声检查的住院患者进行研究。评估了七个临床标准：开始适当抗生素治疗后持续发热超过72小时、既往尿路感染发作史、既往肾结石病史、尿路解剖异常、绞痛、持续性血尿和妊娠。根据这些标准将患者分为两组：a）有指征超声检查（IE）组，适用于至少符合上述一项标准的患者；b）无指征超声检查（NIE）组，适用于不符合上述任何标准的患者。
IE组由47例患者组成，其中18例（38%）超声检查正常；NIE组由53例女性组成，其中51例（96%）超声检查正常。IE组有11例患者（23%）因超声检查异常而改变了治疗行为，NIE组有2例患者（4%）出现这种情况。
在没有支持复杂性APN存在的临床数据的情况下，对诊断为APN的女性常规进行腹部超声检查并无必要。
