您现在的位置: 首页 > 个人微信号 > 鞋包 > 尿路感染症状|【药我说】尿路感染,女性的难言之隐

微信扫一扫,添加关注

尿路感染症状|【药我说】尿路感染,女性的难言之隐

【药我说】尿路感染,女性的难言之隐广州中医药大学一附院微信订阅号【药我说】专栏,逢周二推送!栏目文章均由医院药学部药师撰写。内容涵盖各种合理用药知识,实用、精彩!敬请关注!尿路感染,女性的难言之隐文/药学部熊芬主管药师尿路感染是指病原微生物

微信号: 720weixin

联系QQ: 720weixin

28

热度

其他信息

  • 行业:鞋包
  • 地区:郑州市
  • 时间:2021-04-13
  • 标签:720weixin
尿路感染症状|【药我说】尿路感染,女性的难言之隐
  • 0个评论

  • img

  • 720次点赞

  • 0个收藏

尿路感染症状|【药我说】尿路感染,女性的难言之隐的详细说明:

【药我说】尿路感染,女性的难言之隐


/广州中医药大学一附院微信订阅号【药我说】专栏,逢周二推送!栏目文章均由医院药学部药师撰写。内容涵盖各种合理用药知识,实用、精彩!敬请关注! 


尿路感染,女性的难言之隐

文/药学部 熊芬主管药师


ν
ː

Я尿路感染 是指病原微生物在肾脏、输尿管、膀胱和尿道异常繁殖所致的急性或慢性炎症。女性每年尿路感染的发病率近10%,无论是孕龄期还是绝经期的女性,均易发生,是很多女性难以启齿的难言之隐。


ㅛ┛尿路感染症状
Ι

为什么尿路感染更好发于女性?

这与女性的生理结构和行为活动有关。女性尿道短而宽,距离肛门较近,尿道口开口于阴唇下方,尤其是在性生活时可将尿道口周围的细菌挤压入尿路引起感染。而避孕用品:如杀精剂、避孕套和口服避孕药均可诱发尿路感染。


对妊娠期的女性而言,孕激素分泌增多致输尿管蠕动减弱,膀胱输尿管活瓣关闭不全,妊娠后期子宫增大压迫尿路致尿流不畅等易诱发感染。


对绝经期的女性而言,绝经后雌激素缺乏,阴道黏膜萎缩,尿道口受牵拉而暴露尿道黏膜,尿道闭合性降低;同时,阴道黏膜变薄,阴道内糖原消失,pH值升高,菌群发生改变,局部抵抗力下降,诱发绝经后尿路感染。


й
۞

尿路感染的分类

按照不同的标准有不同的分类方法:


1. 按照生理状态,可分为:非妊娠绝经前尿路感染、妊娠尿路感染和绝经后尿路感染。


2. 按照临床表现,可分为:单纯性尿路感染、复杂性尿路感染(患者存在尿道结构异常、结石或糖尿病、免疫抑制等基础疾病)、反复发作的尿路感染(在12个月内出现尿路感染3次或以上)、无症状性菌尿和尿道综合征。


3. 按照解剖部位,可分为:㈌上尿路感染(肾盂肾炎)和下尿路感染(膀胱炎和尿道炎)。


◀☌

尿路感染有哪些表现?

临床表现复杂多样,差异很大,患者可为无症状性菌尿(亚临床感染);也可有如下典型症状:


1. 尿道炎:发作性尿痛、尿频,多无血尿和耻骨联合上疼痛。


2. 膀胱炎:通常表现为尿频、尿急、尿痛及下腹部疼痛。尿液常混浊、并有异味,30%的患者可见血尿。


3. 急性肾盂肾炎:尿急、尿频、尿痛、腰痛、排尿困难等泌尿系统症状,同时可伴有发热、寒战、恶心、呕吐等全身症状,严重的出现尿脓毒血症。


尿路感染如何治疗呢?

1. 生活习惯调理:充足睡眠、多饮水、及时排尿,穿棉质内衣裤,不穿紧身的牛仔裤和尼龙内衣裤等。注意个人卫生,性生活前,男女均应清洗会阴部,性生活后应立即排尿一次,冲刷细菌。


2. 针对病原菌的治疗:及时去医院ん就诊,在专科医生的指导下,做相应的检查,选择有针对性的抗菌药物进性治疗;中成药或中药汤剂,对于尿路感染的治疗,也能发挥不错的效果。


3. 对于复杂性尿路感染,属于无症状性菌尿时,不建议常规抗感染治疗。对于有症状的尿路感染,除进行抗感染治疗外,需要进行去除或减轻复杂因素的治疗。


4. 妊娠期尿路感染严重影响母婴健康,可导致母体羊膜炎、贫血甚至败血症;胎儿低体重、早产甚至死产。妊娠期,即使是无症状性菌尿,也应给予抗菌药物积极治疗。


5. 绝经后尿路感染多是非复杂性尿路感染,临床表现常为无症状性菌尿,少数表现为症状性尿路、感染和反复发作的尿路感染反复发作尿路感染。对于反复发作的绝经后尿路感染,推荐在应用雌激素治疗的基础上预防性应用抗生素。无症状性细菌尿不宜使用抗 生素;对于只有泌尿生殖系统症状,但实验室检查未能证实为尿路感染的绝经后女性,不宜给予经验性抗菌治疗。


〣>
Μ

々需要治疗多久才停药呢?

1. 单纯的下尿路感染:3~7天。

Ö

2. 轻、中度的急性肾盂肾炎:疗程7~14天。


3. 重症肾盂肾炎:以住院治疗为主,疗程 7~14天。当药敏结果为耐甲氧西林金黄色葡萄球菌 (MRSA)阳性时,总疗程延长至 14~21天。


4. 反复发作的尿路感染,可给予持续抗生素治疗,如甲氧苄胺嘧啶/磺胺甲噁唑、呋喃妥因、头孢氨苄、喹诺酮类等1次/日,逐渐减量至3次/周,口服6~12个月至停药,再评估病情。


尿路感染是一种常见而痛苦的疾病,有资料表明,50%~80%的女性一生中至少会患上1种尿路感染。幸运的是,目前它对药物的治疗反应快,去正规医疗机构及时就诊,就能快速解决这个小烦恼啦!



〓ト

作者简介

尿路感染症状

熊芬,药学部主管药师。呼吸专业和抗感染专业临床药师,中ロ华中医药学会中药临床药师培训基地带教老师。20┎16年取得美国药师协会治疗药物管理服务(MTMs)证书。


擅长:支气管哮喘、慢性阻塞性肺病、以及感染性疾病的治疗方案评估、个体化用药指导和慢病管理;孕产妇和儿童用药指导㎝。


出诊时间:☃周五上午。



温馨提醒:

请关注下方“广州中医药大学一附院”或“广州中医药大学第一附属医院” 公众号。关注后进入页面菜单栏“就诊助手”或“门诊服务”,搜索“医生姓名”即可挂号。


编辑:杨艳

复核:郑小英、刘庆钧

责编:冯殷

审定:方宁


觉得不错,请点赞↓↓↓

Ø


s
Α


[Medicine, I say] Urinary tract infection, the unspeakable concealment of women, Guangzhou University of Chinese Medicine First Affiliated Hospital WeChat subscription number [Medicine, I say] column, posted every Tuesday! Column articles are written by pharmacists of the Department of Pharmacy of the hospital. The content covers a variety of rational drug use knowledge, practical and exciting! stay tuned! u0026nbsp;Urinary Tract Infections, Unspeakable Hidden Words for Women/Pharmacy Department Xiong Fen, Chief Pharmacist Urinary Tract Infectionu0026nbsp;refers to acute or chronic inflammation caused by the abnormal reproduction of pathogenic microorganisms in the kidneys, ureters, bladder and urethra. The annual incidence of urinary tract infections in women is nearly 10%. Both gestational age and menopausal women are prone to occur, which is difficult for many women to say. Symptoms of urinary tract infection Why do urinary tract infections occur more often in women This is related to the physiological structure and behavior of women. Female urethra is short and wide, close to the anus. The opening of the urethra is below the labia, especially during sex, the bacteria around the urethra can be squeezed into the urinary tract to cause infection. And contraceptives: such as spermicide, condoms and oral contraceptives can induce urinary tract infections. For women during pregnancy, increased secretion of progesterone leads to weakened ureteral peristalsis, vesicoureteral valve insufficiency, and late pregnancy uterine enlargement and compression of the urinary tract, which can easily induce infections. For menopausal women, postmenopausal estrogen deficiency, vaginal mucosa shrinks, urethral opening is stretched to expose urethral mucosa, urethral closure is reduced; at the same time, vaginal mucosa becomes thinner, glycogen disappears in vagina, and pH value rises , The flora changes, local resistance drops, and postmenopausal urinary tract infections are induced. The classification of urinary tract infection has different classification methods according to different standards: 1. According to the physiological state, it can be divided into: non-pregnant premenopausal urinary tract infection, pregnancy urinary tract infection and postmenopausal urinary tract infection. 2. According to clinical manifestations, it can be divided into: simple urinary tract infection, complex urinary tract infection (patients with urinary tract structural abnormalities, stones or diabetes, immunosuppression and other basic diseases), recurrent urinary tract infections (in 12 months Urinary tract infections occurred 3 times or more), asymptomatic bacteriuria and urethral syndrome. 3. According to the anatomy, it can be divided into: upper urinary tract infection (pyelonephritis) and lower urinary tract infection (cystitis and urethritis). What are the manifestations of urinary tract infections The clinical manifestations are complex and diverse, with great differences. Patients may have asymptomatic bacteriuria (subclinical infection); they may also have the following typical symptoms: 1. Urethritis: paroxysmal dysuria, frequent urination, no hematuria and suprapubic symphysis pain . 2. Cystitis: usually manifested as frequent urination, urgency, painful urination and lower abdominal pain. Urine is often cloudy and smelly, and 30% of patients have hematuria. 3. Acute pyelonephritis: Urinary system symptoms such as urgency, frequent urination, painful urination, low back pain, dysuria, and systemic symptoms such as fever, chills, nausea, and vomiting, and severe urosepsis. How to treat urinary tract infection 1. Living habits conditioning: get enough sleep, drink plenty of water, urinate in time, wear cotton underwear, not tight jeans and nylon underwear, etc. Pay attention to personal hygiene. Both men and women should wash the perineum before sex, and urinate immediately after sex to flush bacteria. 2. Treatment of pathogenic bacteria: go to the hospital in time, do corresponding examinations under the guidance of specialists, and choose targeted antibacterial drugs for progressive treatment; Chinese patent medicines or Chinese medicine decoctions are also useful for the treatment of urinary tract infections. Can play a good effect. 3. For complex urinary tract infections, asymptomatic bacteriuria, conventional anti-infective treatment is not recommended. For symptomatic urinary tract infections, in addition to anti-infective treatment, treatments to remove or reduce complex factors are needed. 4. Urinary tract infections during pregnancy seriously affect the health of mothers and babies, and can lead to maternal amniotic inflammation, anemia and even sepsis; low birth weight, premature delivery and even stillbirth. During pregnancy, even asymptomatic bacteriuria should be actively treated with antibiotics. 5. Postmenopausal urinary tract infections are mostly uncomplicated urinary tract infections, the clinical manifestations are often asymptomatic bacteriuria, and a few are symptomatic urinary tract infections and recurrent urinary tract infections and recurrent urinary tract infections. For recurrent postmenopausal urinary tract infections, it is recommended to use prophylactic antibiotics on the basis of estrogen therapy. Antibiotics should not be used for asymptomatic bacteriuria; for postmenopausal women who have only genitourinary symptoms but cannot be confirmed as urinary tract infections in laboratory tests, empirical antibacterial treatment should not be given. How long does it take to stop the treatment 1. Simple lower urinary tract infection: 3~7 days. 2. Mild to moderate acute pyelonephritis: The course of treatment is 7 to 14 days. 3. Severe pyelonephritis: The main treatment is hospitalization, and the course of treatment is 7 to 14 days. When the drug sensitivity result is positive for methicillin-resistant Staphylococcus aureus (MRSA), the total course of treatment is extended to 14-21 days. 4. Recurrent urinary tract infections can be treated with continuous antibiotics, such as trimethoprim/sulfamethoxazole, nitrofurantoin, cephalexin, quinolones, etc. once a day, gradually reduce the dose to 3 times a week, orally 6 to 12 months until the drug is stopped, and then evaluate the condition. Urinary tract infection is a common and painful disease. Data shows that 50% to 80% of women will suffer from at least one urinary tract infection in their lifetime. Fortunately, it has a fast response to drug treatment at the moment. If you go to a regular medical institution to see a doctor in time, you can quickly solve this little trouble! The author is briefed on the symptoms of urinary tract infection Xiong Fen, a pharmacist in charge of the Department of Pharmacy. Respiratory and anti-infective clinical pharmacists, and teachers of the Chinese Medicine Clinical Pharmacist Training Base of the Chinese Society of Chinese Medicine. In 2016, he obtained the Certificate of Therapeutic Drug Management Services (MTMs) of the American Pharmacists Association. Good at: evaluation of treatment plans for bronchial asthma, chronic obstructive pulmonary disease, and infectious diseases, individualized medication guidance and chronic disease management; medication guidance for pregnant women and children. Visiting time: Friday morning. Warm reminder: Please pay attention to the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine or First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine below. After paying attention, enter the menu bar of the page seeing assistant or outpatient service, search for doctors name to register. Editor: Yang Yan Review: Zheng Xiaoying, Liu Qingjun Responsible Editor: Feng Yin Approval: Fang Ning feels good, please like it↓↓↓

其他文章

登录

使用微信帐号直接登录,无需注册