Urethral infection is generally divided into upperUrinary tract infectionAnd lower urinary tract infection.PressBacteriaThe ways of invasion can be divided into bloody infection, ascending infection and descending infection.Most women are infected upwardly. This is because the female urethra is straight and short, and bacteria are easy to go up to the bladder to cause infection. In addition, the external opening of the female urethra is close to the vaginal opening and anus, and is easy to be contaminated by feces and bacteria excreted in the vagina. In addition, the complete emptying ability of the bladder of elderly women is reduced, and bacteria are very easy to remainurineMedium reproduction.The common clinical symptom is lower urinary tract infectioncystitisIt is a common and frequently occurring disease in elderly women, and its incidence rate is 8-10 times higher than that of men, so prevention is very important.
Healthy people,bladderThe urine inside is sterile, that is, noneBacteriaOr other infectious microorganisms.takebladderThere is no infection in the urethra, the tube through which urine is discharged from the bodySTDThe pathogen or only a few pathogens will not cause infection.However, any part of the urinary tract can be infected. These infections are usually divided into lower urinary tract or upper urinary tracturinary tract infection。lowerurinary tract infectionrefer tobladderOr urinary tract infection;Upper urinary tract infectionrefer tokidneyOr ureteral infection.[1]
pathogeny
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pathogenIt usually invades the urinary tract through one of two ways.So far, the most common route is through the lower end of urinary tract -- malePenisEnd opening or femalevulvaThe result is an upward spread infection through the urethra;Another possible route is direct infection through blood sourcekidney。Bacteria、Viruses, fungi or manyparasiteCan causeurinary tract infection。
Route of infection
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It is generally believed that the route of urinary tract infection includes ascending infection, bloodstream infectionlymphThere are four ways of infection: road infection and direct infection.
(1) Ascending infection: Most urine sensation is caused by ascending infection.Normally, there areBacteriaParasitic, but generally does not cause infection.When the resistance of the body decreases or the urethral mucosa is slightly damaged, orBacteriaIt is highly toxic, has strong ability to adhere to urethral mucosa and ascend, and is easy to invade bladder andkidney, causing infection.Because the female urethral orifice is close to the anus, and the female urethral orifice is much shorter and wider than the male urethral orifice, the female urethral orifice is oftenfaecesPollution, so it is more likely to cause disease.
(2) Blood line infection:BacteriaFrom the infection focus in the body (such asamygdalitis、nasosinusitis, dental caries or skin infection) invade the blood streamkidney, first caused multiple small abscesses in the renal cortex, thenRenal tubuleIt diffuses downward to the renal papilla, calyces and pelvis mucosa, but inflammation can also start from the papillary collecting duct with slight damage at the renal papilla (such as crystal damage in urine), and then spread upward and downward.Blood route of infection is rare, less than 10%.Blood line infection is more common in newborns, or Staphylococcus aureussepticemiaThe patient's hematogenous renal infection.
(3) Lymphatic infection: there are many communicating branches between the lymphatic vessels of the lower abdomen and pelvic organs and the lymphatic vessels around the kidney, and between the ascending colon and the right kidney.When pelvic organ inflammation, appendicitis andcolitisWhen,BacteriaIt can also be infected from the lymphatic systemkidney。This route of infection is more rare, and even whether this route of infection exists is still controversial.
(4) Direct infection: trauma or adjacentkidneyWhen the organs of,BacteriaIt can directly invade the kidney to cause infection, but this situation is very rare clinically.
5. Urine colony count>10 to the 5th power/ml, and for those with symptoms such as urinary frequency,>10 to the 2nd power/ml is also meaningful;The 3rd power of coccus 10 - the 4th power of coccus 10/ml also has diagnostic significance;
6. One hour urine sediment count: 200000 white blood cells
4. All patients are encouraged to drink more water, and patients who drink less water should be given infusion to ensure that the daily urine volume is more than 2000ml.
5. Some patients can take Chinese medicine together.Sanjin Tablets, Yinhua Biyanling Tablets, etc
Expert tips
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urinary tract infection, mostly seen in women of childbearing age, attentionvulvaIt is very important to keep clean.urinary tract infectionThere are many incentives, so we should carefully check whether the patient hasUrolithiasisWhether the kidney or ureter is deformed.In addition to drug treatment, drink more water to keep the daily urine volume above 2000ml, which plays a role in flushing the urinary tracturinary tract infectionTreatment is also important.In addition, at present, gonococcalurethritisIt is also very common, if any, you should pressgonorrheatreatment.Application of traditional Chinese medicineurinary tract infectionHas accumulated a lot ofclinical experienceIt can be used for clearing away heat and toxic substances such as isatis root, rehmannia root, patrinia villosa, plantain, etc. In addition, attention should be paid to strengthening nutrition and strengthening physique.
2. Other urinary tract abnormalities: causing urinary tract abnormalitiesAcquired factorMore, such asNeurogenic bladderWeak contraction, foreign body, tumor, stenosis and changes caused by trauma, surgery or radiation lead to decreased bladder emptying function and increased residual urine volume.If the pressure in the lumen of the urinary tract rises, or a section of the urinary tract is excessively dilated, or there is a urinary tract intubation,BacteriaIf it enters the bladder, it is easy to cause reproductionurinary tract infectionOccurrence of.
Lower urinary tract infection
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Vesical and urethralBacteriaSexual inflammation, collectively referred to asLower urinary tract infection, the common pathogenic bacteria areEscherichia coliStaphylococcus and Staphylococcus, most of which are secondary, are more common in women.Common causes include urethral obstruction, inflammation of adjacent organs, bladder or urethral instrument examination, traumaMasturbationEtc.
clinical manifestation
lowerurinary tract infectionThe main performance points of,Urinalgia, or mucinous secretion.inspecturineThere are pus cells and a few red blood cells.
treatment
It includes: ① enhancing the body resistance, treating the primary focus and eliminating the clothing and hair factors; ②Drink more water, hot water comes to the bottom or 1:50000potassium permanganateSolution sitz bath; ③Anti infection: 1g Synergetic Sulfonate can be selected, twice a day,gentamicin80000 units, three times a day,norfloxacin0.2g, 3 times a day, severe cases canIntravenous dripAmpicillin 2-4g orAmikacin0.4-0.6g; ④For those with obvious symptoms of urethral irritation, appropriate antispasmodic and analgesic drugs, such as anisodamine 5-10mg, can be taken orally 3 times a day, oratropineTablets 0.3-0.6 mg, 3 times a day.
(1) The baby girl should change the diaper in time after defecation, wash the perineum and buttocks, and the diaper used must be clean.Children after the age of 1, both men and women, should wear hidden pants and not sit on the spot to avoidvulvaAnd urinary tract infection.
(2) Adults should wash dailyvulvaOnce, change frequentlyunderpantsAfter defecation, wipe the anus from front to back to avoid bringing anal dirt to the urethral orifice.
(3) No sitz bath If you bathe in a bathtub, the sewage is easy to soak into the urethra, causing infection.Because the female urethra is short and wide, and the urethral orifice is close to the vagina and anus, special attention should be paid.
2. Pay attention to sexual hygiene.Urinary infectionThe cause of the disease, poor sexual hygiene habits are more common, both men and womenvulvaOr vagina, urethragermsIt is very easy to pass on to the other party, and also easy to infect itself.Therefore, the external genitalia should be cleaned before sex.If contraceptives are used, they should be washed or disinfected.Sexual intercourseBefore and after, urinate once.In addition, quit masturbation, especially with utensils, to prevent urinary tract infection and injury.
(1) When you feel like urinating, urinate in timeSuffocationEmpty your arms before going to bed every night.
(2) For women who are pregnant for more than 5 months, it is better to lie on the left and right side when sleeping, so as to prevent the uterus from pressing the ureter and causing poor urine flow.
(1) Actively treat infectious diseases, such as tonsillitis, skin swelling or traumatic infectioncholecystitis、pelvic infection、appendicitisProstatitis, caries infection, sinusitis, etc., should be treated with sufficient drugs and thoroughly cleaned to prevent bacteria from entering the urinary system through the blood and lymphatic channels, and to kill bacteria that have invaded the urinary tract.
(2) Drink more boiled water, increase urine outputurineConstantly flush the urinary tract and discharge it as soon as possibleBacteriaandtoxinKeep the urinary tract clean.
5. Radical cure and change prevention.
(1) Thorough treatment: it has been foundUrinary infectionOf the patients, we should take adequate medication within a sufficient period of treatment, and we should not take it lightly.Intermittent treatment or premature drug withdrawal may lead to chronic disease.Generally, after the symptoms disappear completely,Urine examinationAfter returning to normal, continue to use the drug for 3-5 days. After stopping the drug, recheck the urine once a week. If no abnormality is found for more than 3 consecutive times, it can be considered as basically cured.
(2) Slow searchSTDCause: For chronic patients, it is necessary to find out the reasons for the delay and see if there is anyUrinary obstructionOr other infectious diseases, especially those at the urethral orifice;Whether it causes the engine bodyResistanceReducedChronic consumptive diseaseSuch as diabeteshepatopathy, tumortuberculosisOtherskidney troubleEtc;Are you still taking it recentlyImmunosuppressionDrugs such as prednisoneKunming CrabapplePenicillin and anti-tumor drugs;Whether the medicine is used irregularly against the doctor's advice.Then targeted prevention and treatment, and strive for early recovery.
(3) Long term follow-up observation: chronicUrinary infectionA complete cure is a long-term thing and should be followed up.If the symptoms reappear within 6-9 weeks after drug withdrawal, it should be regarded as re infection or recurrence of the original disease, and the drug should be recruited continuously for about half a year.Monthly reexamination is still required for half a year after drug withdrawalurineIf there are signs of recurrence, treat it immediately to prevent the disease from evolving to the enduremiaEtc.
6. Suitable dynamic and static conditions.Strengthening physical exercise and strengthening physique is to prevent occurrenceUrinary infectionImportant aspects of.Once infected, in the acute period of fever and abnormal urine test, you should stay in bed and rest.During the recovery period, we should participate in moderatephysical activityAvoid physical weakness and delay.The way of activity may vary from person to person, but fatigue is not allowed.
7. Drug prevention.
(1) Car front grass, dandelion, honeysuckle, wormwoodWhite thatch rootWait for light frying or soaking, and drink it as a substitute for tea.
(2) 9 grams of luffa seeds, baked and ground, served with yellow rice wine, once a day or twice a day.
（3）Mung beanClothes or mung beans, boiled in sauce
(4) 60 grams of honeysuckle and 120 grams of sugar are fried together, and taken frequently.Or 120g honeysuckle vine, fried in water.
(5) 15 grams of thistle grass,Malangen15g, fried in water.
