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目的:分析本市市区及其周边地区无症状小儿泌尿系统患病特点及超声在筛查无症状小儿泌尿系统异常中的作用。方法:对2008年9月至2008年10月集中在我院进行泌尿系统超声筛查的14256名无症状小儿按年龄、性别、发病部位及病变程度分组进行统计分析。结果:共筛查泌尿系统异常患儿409例,总患病率为2.87%;其中明显异常284例,依次包括肾积水、肾结石、输尿管扩张、肾发育异常、肾囊性病变、重复肾等;以肾积水最多,130例,占45.77%(130/284),男性患病率1.18%(92例),而女性为0.59%(38例),男性高于女性,差异有统计学意义(u=13.51,P<0.001)。诉食用三聚氰胺污染奶粉致小儿泌尿系结石机率是未食用三聚氰胺污染奶粉的5.17倍,其总体相对危险度的95%CI为[3.28,8.14]。结论:①超声筛查是发现无症状小儿泌尿系统异常的有效方法;对小儿开展泌尿系统超声筛查,有利于CAKUT、泌尿系结石等疾病的早期诊断及早期治疗,从而减少肾功能衰竭发生的机率;②无症状小儿肾积水男性患病率高于女性;③三聚氰胺是小儿泌尿系结石高发的一个危险因素。
OBJECTIVE: To analyze the prevalence of asymptomatic pediatric urinary system and the role of ultrasound in the screening of asymptomatic urinary system abnormalities in the urban area and its surrounding areas. Methods: From September 2008 to October 2008, 14256 asymptomatic pediatric patients with urinary system ultrasound screening in our hospital were divided into groups according to their age, gender, disease location and degree of lesion. RESULTS: A total of 409 children with abnormal urinary system were screened, with a total prevalence of 2.87%. Among them, 284 patients were significantly abnormal, including hydronephrosis, kidney stones, ureteral dilatation, renal dysplasia, renal cystic lesions, Among them, the highest was hydronephrosis (130 cases, 45.77% (130/284)), the prevalence was 1.18% (92 cases) in males and 0.59% (38 cases) in females, the difference was statistically significant Significance (u = 13.51, P <0.001). The incidence of urinary stones in children with melamine-contaminated milk powder is 5.17 times of that of milk powder without melamine contamination, and the 95% CI of the overall relative risk is [3.28,8.14]. Conclusion: ① ultrasound screening is an effective method to detect asymptomatic pediatric urinary system abnormalities; to carry out ultrasound screening of urinary system in children is conducive to the early diagnosis and early treatment of CAKUT, urinary stones and other diseases, thereby reducing the occurrence of renal failure Probability; ② asymptomatic infantile hydronephrosis male prevalence rate higher than women; ③ melamine is a high risk of urinary tract stones in children a risk factor.