抗生素治疗儿童肾盂输尿管梗阻的效果

Abdusattor Akhatovich Nasirov, F. F. Bayakhmedov, Sayyora Markhamatovna Sobitova, Shakhnozakhon Ikboljon qizi Fozilova, Gulnoza Umidullo qizi Gaybullaeva
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摘要

本回顾性研究于2013年至2018年进行,包括131名产前诊断为III级和IV级肾积水(SFU)的儿童的数据。所有患者在3个月至3岁时接受手术治疗,未接受抗生素预防治疗。尿样中WBC (> 10 WBC/视野)、细菌阳性生长(≥105 CFU/ml)、发热(≥38.5℃)诊断为尿路感染。伴有双系统、梗阻性血压计、膀胱输尿管反流、后尿道瓣膜和神经源性膀胱的儿童排除在本研究之外。III级肾积水113例,IV级肾积水18例。尿路感染的总发生率为9.2%(12例),而IV级肾积水组(18例中3例- 16.7%)高于III级肾积水组(113例中9例- 7.9%)(P <0.05)。尿路感染的发生率并没有因患者的性别和年龄而有显著差异。7例(58.3%)患者在6个月前出现尿路感染,平均年龄为2.7个月。细菌学研究显示,8例(66.7%)患者以大肠杆菌为尿路感染的病原体。由于尿路感染的发生率低,产前诊断和产后确认输尿管肾盂连接处梗阻的儿童不需要抗生素预防。然而,6个月以下的IV级肾积水患者应由医生密切随访,早期诊断和治疗尿路感染。
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Effect of Antibiotic Therapy in Children with Pyelouretheral Segment Obstruction
The present retrospective study, which was conducted from 2013 to 2018 years, includes data of 131 children with antenatally diagnosed grade III and IV hydronephrosis (SFU). All patients underwent surgical treatment at the age from 3 months to 3 years and did not receive antibiotic prophylaxis. Urinary tract infection was diagnosed in the presence of WBC in urine sample (> 10 WBC/field of view), positive bacterial growth (≥105 CFU/ml) and fever (≥38.5 ° C). Children with duplex system, obstructive megaureter, vesicoureteral reflux, posterior urethral valve, and neurogenic bladder were excluded from this study. Grade III hydronephrosis was detected in 113 children and grade IV in 18 patients. The total incidence of urinary tract infection was 9.2% (12 patients), while in the group of children with grade IV hydronephrosis it was higher (in 3 of 18 - 16.7%) than in children with grade III (in 9 out of 113 - 7.9%) (P <0.05). The incidence of urinary tract infections did not differ significantly depending on the sex or age of the patients. In 7 (58.3%) patients, urinary tract infection was noted before the age of 6 months, with an average age of 2.7 months. A bacteriological study revealed that in eight (66.7%) patients, E. Coli was the causative agent of urinary tract infection. Children with antenatal diagnosed and postnatal confirmed ureteropelvic junction obstruction do not need antibiotic prophylaxis because of the low incidence of urinary tract infection. However, patients with grade IV hydronephrosis under the age of 6 months should be closely follow-up by physicians for the early diagnosis and treatment of urinary tract infection.
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