Cause acute
pyelonephritis turn chronic causes, mostly due to acute phase treatment is not
complete due. As the symptoms of acute phase after treatment, often within a
short period of two or three days to disappear, patients often mistakenly
thought to have cured and termination of treatment. As everyone knows,
disappearance of symptoms does not mean that cure, but should be in the urine
pathogens (mostly E. coli) completely disappeared, and after two review
(culture) negative before withdrawal. General treatment should be about two
weeks, or even longer.
Another cause of
chronic pyelonephritis is repeated infection, that is, do not pay attention to
genital, anal hygiene, or caused by unclean sex.
In order to
prevent acute pyelonephritis turn chronic, it should be done:
First, the acute
phase can not be discontinued due to symptoms and treatment, should obey the
doctor's advice, adhere to treatment until cured.
Second, pay
attention to health, regular cleaning of the genitals and anus, pay attention
to menstrual period and sexual health, drinking water, often urinating, do not
wait until the urgency of urination.
Third, strengthen
physical exercise, pay attention to nutrition, enhance resistance, to prevent
repeated infection.
Fourth,
gynecological chronic inflammatory diseases such as pelvic inflammatory
disease, should also be thoroughly treated to prevent the spread of infection
to the renal pelvis.
Acute
pyelonephritis refers to the renal pelvis and renal parenchymal acute
infectious diseases, mainly E. coli infection, in addition to Proteus,
Staphylococcus, Streptococcus faecalis and Pseudomonas aeruginosa caused. Acute
pyelonephritis with the most serious evidence is toxic shock.
Etiology
There are two ways
of infection
① ascending infection, bacteria into the
renal pelvis from the ureter, and then invade the renal parenchyma. 70% of
acute pyelonephritis is derived from this pathway.
② hematogenous infection, the bacteria into
the renal tubular blood flow from the renal tubular invasion of the renal
pelvis, accounting for about 30%, mostly staphylococcal infection. Urinary
tract obstruction and urinary stagnation is the most common cause of acute
pyelonephritis, pyelonephritis is rare.
Clinical manifestations
Typical acute
pyelonephritis onset, clinical manifestations of paroxysmal chills, fever, low
back pain (ribs at the corner there are obvious percussion pain), usually
accompanied by abdominal cramps, nausea, vomiting, dysuria, Frequent urination
and nocturia increased, the disease can occur in all ages, but the most common
women of childbearing age, mainly the following symptoms.
1. General symptoms
Fever, chills,
body temperature and more in the 38 ~ 39 ℃, but also up to 40 ℃, different heat type, generally showed relaxation
type, but also showed intermittent or missed type, with headache, body aches,
Wait.
2. Urinary tract symptoms
Patients with low
back pain, mostly dull pain or soreness, varying degrees, a small number of
abdominal cramps, along the ureter to the bladder radiation; physical
examination in the upper ureteral point (rectus outside the line with the
umbilical cord cross-point) (Psoas major muscle and 12 ribs cross point)
tenderness, kidney area percussion pain positive, patients often urinary
frequency, urgency, dysuria and other symptoms of bladder irritation, in
ascending infection, can be preceded by systemic symptoms.
3. Gastrointestinal symptoms
May have loss of
appetite, nausea, vomiting, individual patients may have upper abdominal or
abdominal pain.
4. Bacteremia and sepsis
Although the
symptoms of acute pyelonephritis patients, in the course of their disease can
be complicated by bacteremia.
5. Shock and DIC
6. Pediatric patients
Children with
urinary tract symptoms often not obvious, the onset of high fever in addition
to systemic symptoms, often convulsions, seizures, children under 2 years of
age as fever, vomiting, nausea, abdominal discomfort or bad.
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