Li Qi,Cai Miao,Wu Shengde,et al.Analysis of risk factors for upper urinary tract injury in children with neurogenic bladder[J].Journal of Clinical Pediatric Surgery,,21():253-257.[doi:10.3760/cma.j.cn101785-202108049-010]
Analysis of risk factors for upper urinary tract injury in children with neurogenic bladder
- Keywords:
- Urinary Bladder; Neurogenic/PP; Kidney/IN; Kidney/PA; Ureter/IN; Risk Factors
- Abstract:
- Objective To explore the related risk factors of upper urinary tract damage in patients with neurogenic bladder (NB).Methods A total of 151 inpatients diagnosed with NB in Children’s Hospital Affiliated to Chongqing Medical University were selected as the research objects, and the patients were divided into upper urinary tract damage group and upper urinary tract normal group according to whether upper urinary tract damage occurred.The general characteristics (gender, age, length of hospital stay, course of disease, urination pattern, history of previous spinal surgery), clinical symptoms (whether frequency/urgency, dysuria, urinary incontinence, and bladder-rectal syndrome), laboratory results (urine routine, lumbosacral X-ray) and urodynamic results (bladder compliance, with or without OAB) were compared between the two groups.Multivariate Logistic regression analysis was performed on the indicators with statistically significant differences, and the risk factors for upper urinary tract damage in NB patients were screened.Results Using P<0.2 as the screening criteria for one-way ANOVA, it can be found that fever, urinary tract infection, abdominal pressure/other urination patterns, poor bladder compliance, and OAB are the risk factors for upper urinary tract damage in patients with NB. Multivariate analysis of the above indicators showed that abdominal pressure/other urination methods, poor bladder compliance, and OAB were independent risk factors for upper urinary tract damage in patients with upper urinary tract NB (P<0.05).The risk of upper urinary tract damage in patients with poor bladder compliance was 2.712 times that of patients with normal bladder compliance (OR=2.712, 95%CI:1.182-6.224); patients with abdominal pressure/other urination patterns had upper urinary tract damage The risk of CIC was 2.160 times (OR=2.160, 95%CI:1.182-6.224); the risk of upper urinary tract damage in patients with OAB was 2.265 times that of patients without OAB (OR=2.265, 95%CI:1.077-4.763).Conclusion Poor bladder compliance, abdominal pressure/other urination patterns, and OAB are risk factors for upper urinary tract damage in patients with NB.During bladder management, the bladder should be kept in a low pressure state to reduce damage to the upper urinary tract.
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Memo
收稿日期:2021-08-25。
基金项目:国家儿童健康与疾病临床医学研究中心临床医学研究一般项目（NCRCCHD-2020-GP-04）
通讯作者:魏光辉,Email:u806806@cqmu.edu.cn