这个孩子是否有尿路感染?
Nader Shaikh1, Natalia E Morone, John Lopez
1Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. nader.shaikh@chp.edu
JAMA
|December 27, 2007
概括
准确诊断儿科尿路感染 (UTI) 是至关重要的. 虽然发烧或疼痛等个体症状有助于诊断,但结合发现更可靠地识别儿童的尿路感染.
科学领域:
- 儿科脏病学 儿科脏病学
- 传染性疾病 传染性疾病
- 诊断的准确性 诊断的准确性
背景情况:
- 尿路感染 (UTI) 在儿童中很常见,如果不治疗,可能会导致永久性损伤.
- 准确及时诊断儿科尿路感染对于预防损伤至关重要.
研究的目的:
- 系统地审查各种迹象和症状的诊断准确性,以确定婴儿和儿童的尿路感染.
- 评估个人和联合临床发现在尿路感染诊断中的有用性.
主要方法:
- 在MEDLINE和EMBASE数据库 (1966-2007) 中进行了全面的文献搜索,并补充了对文献的手动审查,以前的系统审查,教科书和专家咨询.
- 纳入标准侧重于报告在18岁以下儿童中出现尿路感染的迹象或症状的研究.
- 数据提取和质量评估由两个评估人员独立进行.
主要成果:
- 在婴儿中,高于40°C的发烧,有尿路感染史和上阴部疼痛是显著指标. 没有割礼会增加男性尿路感染的可能性.
- 症状的组合,如没有其他来源的长期发烧,与单个症状相比,改善了诊断准确度.
- 在口头儿童中,腹痛,背痛,尿障,尿频率和新发性尿失禁与增加尿路感染的可能性有关.
结论:
- 个别的症状和症状为儿科尿路感染提供了一些诊断价值,但缺乏明确的准确性.
- 结合多个临床发现可以有效地识别患有尿路感染的可能性较低的儿童,帮助临床决策.
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