尿路感染.ppt

尿路感染
（肾盂肾炎）
病因
◆细菌：大肠杆菌—70%以上
变形杆菌、克雷白杆菌、绿脓杆
菌、葡萄球菌
◆真菌、支原体、衣原体、病毒
发病机制
◆感染途径：上行感染
血行感染
◆机体抵抗力：尿液冲洗；前列腺液杀菌；
尿道粘膜分泌；酸性尿
◆易感因素：尿路复杂因素（梗阻、异物）
泌尿系统畸形、尿路器械、尿道口
周围炎、全身抵抗力差
◆细菌毒力：吸附能力
Double ureters are seen exiting from each kidney and extending to the bladder that has been opened. A small segment of aorta is seen between the normal, smooth-surfaced kidneys.
流行病学
女性多，2~5%
男性：50岁以下罕见
病理
■充血、水肿、炎症细胞浸润
The large collection of chronic inflammatory cells here is in a patient with a history of multiple recurrent urinary tract infections. This is chronic pyelonephritis.
There was a large renal calculus (stone) that obstructed the calyces of the lower pole of this kidney, leading to a focal hydronephrosis (dilation of the collecting system). The stasis from the obstruction and dilation led to infection. The infection with inflammation is characterized by the pale yellowish-tan areas next to the dilated calyces with hyperemic mucosal surfaces. The upper pole is normal and shows good corticomedullary demarcations.
临床表现
■膀胱炎
■急性肾盂肾炎
■无症状细菌尿
膀胱炎
占60%
尿路刺激征（尿频、尿急、尿痛）
30%血尿
无明显全身症状
大肠杆菌多见