病史和理學檢察可協助判斷三個月到五歲兒童泌尿道感染

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學研究所 > 博碩士論文 > Item 310902500/6847

jsp.display-item.identifier=請使用永久網址來引用或連結此文件: https://ir.csmu.edu.tw:8080/ir/handle/310902500/6847

题名:	病史和理學檢察可協助判斷三個月到五歲兒童泌尿道感染 Personal history and physical examinations can help to judge urinary tract infection in children aged 3 months to 5 years old
作者:	李明聲 Lee, Ming-Sheng
贡献者:	中山醫學大學：醫學研究所;林隆堯
关键词:	泌尿道感染;兒童;理學檢查;病史;三個月到五歲 urinary tract infection;children;pediatric;physical examination;history;3 months to 5 years old
日期:	2013
上传时间:	2013-12-23T03:28:46Z (UTC)
摘要:	背景三個月到五歲發燒的兒童和成人相比往往無法準確表達解尿疼痛、頻尿等症狀，判斷他們是否有泌尿道感染需靠驗尿確定，然而在門診許多發燒病人究竟哪些人要驗尿哪些可以再觀察是許多兒科醫師面臨的問題。研究目標尋找哪些病史或理學檢查能提供線索協助臨床醫師判斷三個月到五歲發燒病人有尿道感染。研究設計在門急診中若懷疑耳溫大於攝氏38度的3個月到五歲病人有尿道感染並驗尿時，請醫師在尿液結果出來前填寫病人資料紀錄單，研究者查詢最後驗尿及細菌培養的報告，並與醫師在不知病人是否為尿道感染情形下的紀錄結果做比對，比對時將病人分為三個月到兩歲還有兩歲到五歲兩個族群進行分析，先以單變數羅吉斯回歸分析選取可能的危險因子，再投入多變數羅吉斯回歸分析作出結論。研究結果 410個三個月到兩歲的病人和115個兩歲到五歲的病人被收入在本研究中。我們發現三個月到兩歲的發燒病人若年紀每小一歲、女性、喉嚨無發紅這幾個因子皆使尿道感染機率變高，勝算比分別為5.051 (P<0.001；CI：1.190-3.765)、2.117 (P<0.05；CI：1.190-3.765)、以及1.907 (P<0.05；CI：1.047-3.470)。三個月到兩歲的發燒病人中，有三次以下的腹瀉比三次以上腹瀉的人尿液常規檢查陽性機會高，勝算比為8.80 (P<0.05；CI：1.07-72.09)。兩歲到五歲的病人若發燒且喉嚨無發紅，尿液常規檢查陽性機會高，勝算比為3.672(P<0.05；CI：1.029-13.107)。結論三個月到兩歲的發燒病人在年紀小和女性能預測是否為尿道感染，而三個月到五歲的病人喉嚨無發紅是尿液檢查陽性的預測因子。病史和理學檢查在判斷兒童是否為尿道感染仍具價值。 Background and objectives: Children between 3 months to 5 years old are unable to express their symptoms such as dysuria or urinary frequency compare to adults. The diagnosis of urinary tract infection (UTI) in this group of patients depends on urinary analysis and culture results. Although there are many patients who develop fever in pediatric outpatient clinic, whom should take a urinary test in common daily practice. Objective: To assess what personal history and physical examinations can eke to predict UTI in children between 3 months to 5 years old. Methods: Clinicians in outpatient service filled a medically record sheet when they suspect the patient with UTI, the record sheet was filled before the urine test results. The medical record sheets were compared to the final urinary test results for prediction of UTI. The patients were divided into two groups during analysis, which are 3 months to 2 years of age and 2 years to 5 years of age. Univariate odds ratio was done to find the possible risk factors, and these factors were then adjusted by multivariate odds ratio. Results: There were 410 patients between 3 months to 2 years old and 115 patients between 2 years to 5 years old in this study. We found that in patients between 3 months to 2 years old, the risk factors of UTI were younger age, female gender, and non-injected throat. The odds ratio (OR) among this group were decreased annually by 5.051 (P<0.001；CI：1.190-3.765), and the ORs for female gender and non-injected throat were 2.117 (P<0.05；CI：1.190-3.765), and 1.907 (P<0.05；CI：1.047-3.470), respectively. The risk of positive urinary analysis in patients between 3 months to 2 years old with diarrhea less than 3 times was higher than those with diarrhea more than 3 times, the OR was 8.80 (P<0.05；CI：1.07-72.09). The risk of UTI in patients between 2 years to 5 years old with non-injected throat was higher than those with injected throat, the OR was 3.672(P<0.05；CI：1.029-13.107). Conclusions: Young age and female gender are effective predictive factors for UTI in patients between 3 months to 2 years old. Non-injected throat is a risk factor for positive urinary analysis results among patients between 2 years to 5 years old. History taking and physical examination can help in diagnosis UTI.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/6847
显示于类别:	[醫學研究所] 博碩士論文

文件中的档案:

档案	描述	大小	格式	浏览次数
index.html	博碩士論文	0Kb	HTML	426	检视/开启

在CSMUIR中所有的数据项都受到原著作权保护.

TAIR相关文章

数据加载中.....