中国循证儿科杂志2012，Vol.7Issue(4)：263-268,6.DOI:10.3969/j.issn.1673-5501.2012.04.005
单中心6年先天性肾脏和尿道畸形病因构成分析
Etiological analysis on inpatients with congenital anomalies of the kidney and urinary tract in a single centre in 6 years
张晓娥 1刘佳璐 1徐虹 1毕允力 1阮双岁 1王翔 1陆良生 1葛琳娟 1沈茜 1饶佳1
作者信息
- 1. 复旦大学附属儿科医院,上海,201102
- 折叠
摘要
Abstract
Objective To analyze the diagnosis of congenital anomalies of the kidney and urinary tract ( CAKUT ) in Childrens Hospital of Fudan University from January 2005 to December 2010, and to provide the clues to the early diagnosis of CAKUT. Methods The medical records of CAKUT cases were reviewed. Data of the diagnosis, chief complaint and imaging reports were collected and analyzed between the normal exposure factors and the special exposure factors( stone screening of the melamine incident ). Results A total of 1 358 out of 102 442 patients ( 1. 33% ) were documented as CAKUT during the survey period ( during this period, if a patient was in-hospital more than once, it was calculated as one case ). The mean age was ( 3.0 ± 3.4) years with gender ratio of 2. 05: 1 ( male to female ). (T)The proportion of CAKUT was increased from 2005 to 2010 among inpatients with normal exposure factors( P < 0. 05 ), lower than that in those with special exposure factors in the same period. A total of 112 CAKUT cases that needed surgical interventions were found under the special exposure factors, 24. 4%[ 112/( 227 + 232 ) ] CAKUT cases were found under the normal exposure factors in the same period. ?The major CAKUT diseases included PUJO, VUR, duplex collecting system, UVJO, accounting for 79. 6% of CAKUT cases. (3)406 cases were found with abnormalities by the prenatal B ultrasound examination, and most of them were PUJO, UVJO and ureterocele. 48. 5% ( 658/1 358 )CAKUT patients had urinary system symptoms ( abdominal symptoms , gross hematuria, voiding dysfunction, urinary tract infections with fever and urinary tract infections ). Otherwise, the patients elder than 2 years old with other urinary symptoms were more common than those younger than 2 years old. Patients with febrile urinary tract infections were the most common in the symptomatic CAKUT cases, accounting for 41% ( 270/658 ), among them the number of younger than 2 years old was 3. 2 times of that elder than 2 years old( 206/64 ). (4)B ultrasound examination was performed in the 98. 0% CAKUT patients, the detection rate for VUR and the other abnormalities were 68. 5%. On the basis of B ultrasound results and clinical manifestations, other examinations were performed for the patients including functional examination ( DTPA and DMSA ) for 1 203 cases, morphological examination ( MR, CT and IVP ) on 1 009 cases and MCU for 400 cases. Conclusions PUJO, VUR, duplex collecting system and UVJO were the most common types in CAKUT. Lots of CAKUT cases could be found in the B ultrasound screening, and the cost-benefit analysis is expected in future studies.关键词
先天性肾脏和尿道畸形/肾盂输尿管连接处梗阻/膀胱输尿管反流/双集合系统/输尿管膀胱连接部梗阻/筛查/首发症状Key words
Congenital anomalies of the kidney and urinary tract/ Pyeloureteric junction obstruction/ Vesicoureteral junction obstruction/ Vesicoureteralreflux/ Duplex collecting system/ Screening/ Sympotom of onset引用本文复制引用
张晓娥,刘佳璐,徐虹,毕允力,阮双岁,王翔,陆良生,葛琳娟,沈茜,饶佳..单中心6年先天性肾脏和尿道畸形病因构成分析[J].中国循证儿科杂志,2012,7(4):263-268,6.
