急性肾盂肾炎是什么?
Acute pyelonephritis is a bacterial infection of the kidneys that affects
孕妇更有可能发展pyelonephritisthan women who aren’t pregnant. This is due tophysiological changes during pregnancythat can interfere with the flow of urine.
Normally, the ureters drain urine from the kidney into the bladder and out of the body through the urethra. During pregnancy, the high concentration of the hormone progesterone can inhibit contraction of these drainage ducts. Also, as the uterus becomes enlarged during pregnancy, it can compress the ureters.
这些变化可能导致肾脏从适当排水的尿液中的问题，从而导致尿液停滞不前。结果，膀胱中的细菌可能迁移到肾脏，而不是从系统中冲出。这会引起感染。细菌Escherichia coli(E. coli) is the usual cause. Other bacteria, like克雷伯氏菌肺炎,Proteusspecies, andStaphylococcus,也可能引起肾脏感染。
通常，肾盂肾炎的第一个症状是下背部两侧的高烧，发冷和疼痛。
在某些情况下，这种感染会引起恶心和呕吐。尿症状也很常见，包括：
- 尿频, or the need to urinate often
- urinary urgency, or the need to urinate immediately
- dysuria或排尿痛
- 血尿，或尿液中的血液
Proper treatment of pyelonephritis may prevent serious problems. If untreated, it can lead to a bacterial infection in the bloodstream called败血症. This can then spread to other parts of the body and cause serious conditions requiring emergency treatment.
随着肺部积累，未治疗的肾盂肾炎也会导致急性呼吸窘迫。
怀孕期间的肾盂肾炎是早产的主要原因，这使婴儿面临严重并发症甚至死亡的高风险。
A urine test can help your doctor determine whether your symptoms are the result of a kidney infection. The presence of white blood cells and bacteria in urine, which can be viewed under a microscope, are both signs of infection. Your doctor can make a definitive diagnosis by taking bacterial cultures of your urine.
As a general rule, if you develop pyelonephritis during pregnancy, you’ll be hospitalized for treatment. You’ll be given静脉antibiotics, probably cephalosporin drugs such as cefazolin (Ancef) or ceftriaxone (Rocephin).
如果您的症状无法改善，则可能是引起感染的细菌对您服用的抗生素具有抗性。如果您的医生怀疑抗生素无法杀死细菌，则可能会在您的治疗中添加一种非常强的抗生素（Garamycin）。
尿路内的阻塞是治疗失败的另一个主要原因。它通常是由肾结石或子宫对输尿管的物理压缩引起的。Urinary tract obstructionis best diagnosed through anX射线or an ultrasound of your kidneys.
一旦您的病情开始改善，您可能会被允许离开医院。您将获得7至10天的口服抗生素。您的医生将根据药物的有效性，毒性和成本选择您的药物。经常开处方处方药物，例如甲氧苄啶 - 磺胺甲氧唑（Septra，bactrim）或硝基氟氨酸（大胆碱）。
怀孕后期的复发感并不少见。降低复发风险的最具成本效益的方法是每天服用抗生素剂量，例如硫酸磺胺酸（甘酸糖蛋白）或硝化氟耐药单水合型大晶（Macrobobid），作为一种预防措施。请记住，药物剂量可能会有所不同。您的医生会开处方适合您的东西。
If you’re taking preventive medication, you should also have your urine screened for bacteria each time you see your doctor. As well, be sure to tell your doctor if any symptoms return. If the symptoms return or if a urine test shows the presence of bacteria or white blood cells, your doctor may recommend another urine culture to determine if treatment is necessary.