幼童泌尿道感染的醫療處置與照護

Medical and nursing care for Young children with urinary tract infection

陳千琪(Chian-Chi Chen) ； 許績男(Ji-Nan Sheu)

《弘光學報》 64期 (2011/09) Pp. 57-69

https://doi.org/10.6615/HAR.201109.64.06

摘要

從嬰幼兒期（0-3歲）到學齡前期（3-6歲）的感染性疾病中，泌尿道感染居於第二位。女嬰第一次泌尿道感染的高峰期是嬰兒期及廁所訓練期（1-3歲）；而男嬰第一次泌尿道感染通常會發生在1歲，更容易發生在未割包皮的男嬰。年齡越小的嬰兒，發生泌尿道感染通常與泌尿道結構異常有關，三歲以下之幼童泌尿系統又未發育成熟完成，加上臨床表徵又不具特異性、語言表達有限，若在此時未能立即確立診斷，不僅容易造成腎臟進一步的傷害，更容易因為忽略結構異常，未能給予立即適當的手術矯正，在反覆的泌尿道感染中造成腎臟結痂，嚴重時更容易造成末期腎衰竭。本文乃針對幼童發生泌尿道感染的相關因素、臨床表徵、醫療處置及照護，期望能提供臨床護理人員對此疾病之了解、增加敏感度，讓幼童能早期確定診斷早期接受適當處置，並有助於在未來照顧此病人之照護依據，提供發展完整的照護計畫，適當給予衛教，進而降低疾病造成的傷害。

關鍵字

幼童 ； 泌尿道感染

並列摘要

The second most common cause of infection disease in early childhood(Ages 0~3) and preschool age （Ages 3~6）is urinary tract infection. The peak age of first time urinary tract infection in girls is seen during infancy and toilet training period（Ages1~3）. On the other hand, for boys, first times urinary tract infection is commonly seen at age one, especially in uncircumcised boys. The underlying cause of urinary tract infection seen in early childhood is related to congenital urinary tract infection. Delayed diagnosis of urinary tract infection is frequently seen in the early childhood group（below3 years old）because of incomplete maturation of the urinary tract, ambiguous symptoms and signs, atypical clinical manifestation and lack of accurate expression of symptoms. Thus, recurrent urinary tract infection may result and further progress to renal scaring or end stage renal failure. This study was conducted to explore the underlying cause, clinical symptoms and signs, medical intervention, patient care and to provide adequate knowledge for children diagnosed with urinary tract infection. Moreover, this study further emphasize the importance of early diagnosis and good quality care for these children, hoping to decrease harm caused by urinary tract infection.

並列關鍵字

Young Children ； Urinary Tract Infection

參考文獻

李慈音（2002）‧兒童泌尿生殖系統疾病及其護理‧陳月枝總校閱，實用兒科護理（二版，499-502頁）‧台北：匯華。

沈賈堯(2007)‧泌尿系統‧蘇雪月、莊順發、鍾麗琴、戴瑄、沈賈堯合著，幼兒生理學 （三版，314-329頁）‧台北：華都文化。

邱南昌（2001）‧新生兒感染‧洪漢陽主編，臨床新生兒科學 （三版，626-627頁）‧台北：嘉洲。

胡雅玲(2008)‧兒童泌尿生殖系統的健康照護‧陳月枝等合著，實用兒科護理學（初版，13-1-13-65頁）‧台中：華格那。

班仁知、游文瓊(2001)‧導尿管相關泌尿道感染之預防措施‧院內感染控治雜誌 ，11(6)，382-387。