尿道炎

很久沒有update blog 了因為嘉晨和我都病倒了.
上兩個星期五, 我記得才跟嘉晨慶祝三歲生日,隔天晚上嘉晨就發燒病倒了.而且嘉晨還一直小便.我和嘉晨的爸就擔心嘉晨會不會得到尿道炎.
隔天早上,我便帶嘉晨看醫生.唉!真的給我和嘉晨的爸猜中了, 嘉晨真的得到尿道炎.我對尿道炎這個病還很新,所以便問了醫生幾個問題

我:為什麼我的孩子會得到尿道炎？
醫: 你的孩子是不是幾天大一次便?
我: 是.
醫: 對了,你孩子幾天才大一次便,所以他的糞便都堆在肝門,細菌就從他的肝門糞便跑到尿道,尿道就受到感染而得到尿道炎.
我: 尿道炎這個病嚴重嗎? 會發燒?會有甚麼後遺症嗎？
醫：尿道炎是一種嚴重的病因為它可以導致死亡．你的孩子已經三歲了而且還是第一次感染到尿道炎所以不用那麼擔心．如果你的孩子是一歲多而又常常感染到尿道炎的話就要做全身檢查，看其他身體部份是否有受到細菌感染．我還是會拿你孩子的尿來檢驗看有甚麼細菌．
尿道發炎是會引起發燒而最怕的就是尿道的細菌會跑到腎而導致腎發炎，那時就會引發恐怖的高燒，手尾就會很長了．
我：尿道炎幾天才會好？有甚麼藥可以對抗尿道炎嗎？
醫：通常要拿３－４天才能好．抗生素就能殺死尿道炎的細菌了．

然後，醫生就跟我拿了１８０元的醫藥費．幸好，公司幫我ｃｏｖｅｒ．
回到家，嘉晨的燒就在３７．８－３８．２．晚上，燒到３８．４，還好臨睡前燒就退了．
可是嘉晨一直小便，１５分鐘小一次便．還好，嘉晨也沒有講痛．臨睡前，只要嘉晨一躺在床上，他就說要小便．３０秒小一次便，小到嘉晨自己也不耐煩而發火了．嘉晨就索性不穿褲子就坐在尿桶旁邊，想小便就直接站起來小便．每次只小一，兩滴尿而已．最後，小到嘉晨趴在地上哭到睡著．真可憐！嘉晨真是多災多難．

尿道炎
什麼是尿道感染 ?

尿道感染俗稱尿道炎，就是細菌在尿道中造成尿道的發炎。正常的尿道是無菌的狀態，但細菌進入尿道後，就會造成尿道的發炎，細菌可經由尿道口跑到膀胱，有時候可以上溯至腎臟，而造成腎孟腎炎。細菌除了從尿道口地到尿道以外，也可以經由血液跑到尿道中，當細菌造成尿道發炎以後，細菌常常會殘留在腎臟或是尿道結石或是在攝護腺中，在這些器官中不斷的生長，造成慢性的尿道炎。
尿道炎的症狀?

尿道炎的症狀包括 :一、疼痛，在膀胱的部位或是下背部發生疼痛。二、灼熱感，排尿時有灼熱感。三、尿感常常會有如刺的感覺。四、夜尿，晚上會起來小便。五、血尿。六、尿液混濁或是尿液有惡臭。嚴重的病人，發燒發冷常常會發生，同時並有嚴重的背痛，在肋骨下會有嚴重的疼痛。可是有些病人的尿道炎完全沒有症狀。如果有上老症狀走否表示有尿道炎？不，有以上的症狀不一定表示有尿道炎，其他原因例如吸煙、喝酒、喝咖啡或是膀胱發炎也會有以上的症狀，不一定是有細尿道炎菌跑到尿道造成尿道炎。
我如何知道自己有尿道炎 ?

尿道炎的診斷非常簡單，只要用一般的尿液檢查以及尿道評量就可以診斷出是否患有尿道炎。
是什麼原因造成尿道炎尿道炎是細菌跑到尿道中造成的、常見的細菌是大腸桿菌，其他常見的細菌是在腸胃道的細菌。
哪一些病人比較容易得到尿道炎呢 ?

如果有攝護腺肥大、尿道結石或是腎臟結石和婦女，都比較容易得到尿道發炎。
尿道炎如何治療?尿道炎可以利用抗生素有效的治療，大部份的抗生素都可以治癒尿道炎，尿道炎的治療最重要的是避免慢性尿道炎的發土，為避免慢性尿道炎的發生，必須有效的把細菌清除，一般的治療過程需要兩星期至三個月不等，在這段期間你必須與你的醫生配合，以清除尿道的細菌，達到有效的完全治療。
尿道炎有幾種?

尿道炎大蓋分做兩種 : 一、膀胱炎。膀胱炎最常會發生，小便灼熱感或是小便有刺痛感。二、腎臟發炎以及腎孟腎炎，腎孟腎炎比較不常發生，但腎孟腎炎　　發生時較為嚴重，此時會有高澆、背痛、惡心、嘔吐等症狀，　　有時候被誤診為上呼吸道感染或是感冒，這時候必須請腎臟科　　專科醫師治療，才可以有效的治療。
尿道炎需要什麼檢查?
當小孩有尿道炎的時候必須進一步的檢查，此外，婦女一年有兩次以上的尿道炎也需要進一步的檢查，男性有尿道發炎的情形也必須進一步的檢查。深層的尿道檢查包括 X光月以及超音波，以找尋尿道是否有異常。
什麼人比較容易得到尿道感染?
下列病人會比較容易得到尿道感染 :一、女性。二、年紀大的老年人。三、糖尿病病人。四、有尿道結石或是攝護腺肥大的病人。五、病人需要使用等尿管。上述病人比較容易得到尿道發炎的機會，尤其是女性，女性因為尿道口比較短，較男性容易得到尿道炎，女性在停經後尿道炎的發生率會上升，因為婦女在停經後賀爾蒙的愛化，使得尿道口減少了保護的能力，較容易發生尿道炎，此外，懷孕的婦女也比較容易得到尿道炎。
為什麼婦女會容易重覆發生尿道炎 ?
很多婦女會重覆的發生尿道炎，最主要的原因是由於細菌在尿道中殘留，細菌會在尿道的上皮上一直殘留而重覆發生尿道炎，這時候必須耐心的給予三個月以上的治療，才能把尿道內的細菌得以完全清除。如何避免發生 尿道炎一、喝水。二、減少瞥尿。三、房事後進行沐浴。四、使用淋浴。
男性為何得到尿道炎 ? 男性得到尿道炎最常的原因是，攝護腺的肥大、攝護腺炎或是尿道有任何的阻塞，都會容易造成男性的尿道炎，所以男性發生尿道炎必須要進一步的檢查。
小孩為何發生尿道炎?

小孩在四歲到八歲中很容易發生尿道炎，主要原因是先天性的尿道異常，特別以小女生較為常見。
小孩如何得知有尿道炎? 家長必須注意小孩有下列的情形 :一、發燒二、注意力不集中三、小便有惡臭四、小便中有血或是水波、粘液有時侯小孩會發生下肢痛，這時候必須要進行尿道的檢查。
尿道炎是否可造成尿毒症? 尿道炎也可以造成尿毒症，不過非常罕見，只要有效的治療，尿道炎很少會進一步的傷害腎臟，造成尿毒症。


Urinary Tract Infections in Children
Urinary tract infections (UTIs) affect about 3 percent of children in the United States every year. Throughout childhood, the risk of a UTI is 2 percent for boys and 8 percent for girls. UTIs account for more than 1 million visits to pediatricians’ offices every year. The symptoms are not always obvious to parents, and younger children are usually unable to describe how they feel. Recognizing and treating urinary tract infections is important. Untreated UTIs can lead to serious kidney problems that could threaten the life of your child.

How does the urinary tract become infected?
Normal urine contains no bacteria (germs). Bacteria may, at times, get into the urinary tract and the urine from the skin around the rectum and genitals by traveling up the urethra into the bladder. When this happens, the bacteria can infect and inflame the bladder and cause swelling and pain in the lower abdomen and side. This bladder infection is called cystitis. If the bacteria travel up through the ureters to the kidneys, a kidney infection can develop. The infection is usually accompanied by pain and fever. Kidney infections are much more serious than bladder infections.
In some children a urinary tract infection may be a sign of an abnormal urinary tract that may be prone to repeated problems. (See What abnormalities lead to urinary problems?) For this reason, when a child has a urinary infection, additional tests are often recommended. (See What tests may be needed after the infection is gone?)
In other cases, children develop urinary tract infections because they are prone to such infections, just as other children are prone to getting coughs, colds, or ear infections. Or a child may happen to be infected by a type of bacteria with a special ability to cause urinary tract infections. Children who frequently delay a trip to the bathroom are more likely to develop UTIs. Regular urination helps keep the urinary tract sterile by flushing away bacteria. Holding in urine allows bacteria to grow. Keeping the sphincter muscle tight for a long time also makes it more difficult to relax that muscle when it is time to urinate. As a result, the child’s bladder may not empty completely. This dysfunctional voiding can set the stage for a urinary infection.

What are the signs of urinary tract infection?
A urinary tract infection causes irritation of the lining of the bladder, urethra, ureters, and kidneys, just like the inside of the nose or the throat becomes irritated with a cold. If your child is an infant or only a few years old, the signs of a urinary tract infection may not be clear, since children that young cannot tell you exactly how they feel. Your child may have a high fever, be irritable, or not eat.
On the other hand, sometimes a child may have only a low-grade fever, experience nausea and vomiting, or just not seem healthy. The diaper urine may have an unusual smell. If your child has a high temperature and appears sick for more than a day without signs of a runny nose or other obvious cause for discomfort, he or she may need to be checked for a bladder infection.
An older child with bladder irritation may complain of pain in the abdomen and pelvic area. Your child may urinate often. If the kidney is infected, your child may complain of pain under the side of the rib cage, called the flank, or low back pain. Crying or complaining that it hurts to urinate and producing only a few drops of urine at a time are other signs of urinary tract infection. Your child may have difficulty controlling the urine and may leak urine into clothing or bedsheets. The urine may smell unusual or look cloudy or red.

How do you find out whether your child has a urinary tract infection?
Only by consulting a health care provider can you find out for certain whether your child has a urinary tract infection. Some of your child's urine will be collected and examined. The way urine is collected depends on your child’s age. If the child is not yet toilet trained, the health care provider may place a plastic collection bag over your child's genital area. It will be sealed to the skin with an adhesive strip. An older child may be asked to urinate into a container. The sample needs to come as directly into the container as possible to avoid picking up bacteria from the skin or rectal area. A doctor or nurse may need to pass a small tube into the urethra. Urine will drain directly from the bladder into a clean container through this tube, called a catheter. Sometimes the best way to get the urine is by placing a needle directly into the bladder through the skin of the lower abdomen. Getting urine through the tube or needle will ensure that the urine collected is pure. Some of the urine will be examined under a microscope. If an infection is present, bacteria and sometimes pus will be found in the urine. If the bacteria from the sample are hard to see, the health care provider may place the sample in a tube or dish with a substance that encourages any bacteria present to grow. Once the germs have multiplied, they can then be identified and tested to see which medications will provide the most effective treatment. The process of growing bacteria in the laboratory is known as performing a culture and often takes a day or more to complete.The reliability of the culture depends on how long the urine stands before the culture is started. If you collect your child's urine at home, refrigerate it as soon as it is collected and carry the container to the health care provider or lab in a plastic bag filled with ice.

How are urinary tract infections treated?
Urinary tract infections are treated with bacteria-fighting drugs called antibiotics. While a urine sample is being examined, the health care provider may begin treatment with a drug that treats the bacteria most likely to be causing the infection. Once culture results are known, the health care provider may decide to switch your child to another antibiotic.
The way the antibiotic is given and the number of days that it must be taken depend in part on the type of infection and how severe it is. When a child is sick or not able to drink fluids, the antibiotic may need to be put directly into the bloodstream through a vein in the arm or hand. Otherwise, the medicine (liquid or pills) may be given by mouth or by shots. The medicine is given for at least 3 to 5 days and possibly for as long as several weeks. The daily treatment schedule recommended depends on the specific drug prescribed: The schedule may call for a single dose each day or up to four doses each day. In some cases, your child will need to take the medicine until further tests are finished.
After a few doses of the antibiotic, your child may appear much better, but often several days may pass before all symptoms are gone. In any case, your child should take the medicine for as long as the doctor recommends. Do not stop medications because the symptoms have gone away. Infections may return, and germs can resist future treatment if the drug is stopped too soon.
Children should drink fluids when they wish. Make sure your child drinks what he or she needs, but do not force your child to drink large amounts of fluid. The health care provider needs to know if the child is not interested in drinking.

What tests may be needed after the infection is gone?
Once the infection has cleared, additional tests may be recommended to check for abnormalities in the urinary tract. Repeated infections in abnormal urinary tracts may cause kidney damage. The kinds of tests ordered will depend on your child and the type of urinary infection. Because no single test can tell everything about the urinary tract that might be important, more than one of the following tests may be needed:
Kidney and bladder ultrasound. An ultrasound test examines the kidney and bladder using sound waves. This test shows shadows of the kidney and bladder that may point out certain abnormalities. However, this test cannot reveal all important urinary abnormalities. It also cannot measure how well a kidney works.
Voiding cystourethrogram (VCUG). This test examines the urethra and bladder while the bladder fills and empties. A liquid that can be seen on x rays is placed into the bladder through a catheter. The bladder is filled until the child urinates. This test can reveal abnormalities of the inside of the urethra and bladder. The test can also determine whether the flow of urine is normal when the bladder empties.
Intravenous pyelogram. This test examines the whole urinary tract. A liquid that can be seen on x rays is injected into a vein. The substance travels into the kidneys and bladder, revealing possible obstructions.
Nuclear scans. These tests use radioactive materials that are usually injected into a vein to show how well the kidneys work, the shape of the kidneys, and whether urine empties from the kidneys in a normal way. Each kind of nuclear scan gives different information about the kidneys and bladder. Nuclear scans expose a child to about the same amount of radiation as a conventional x ray. At times, it can even be less.
Computed tomography (CT) scans and magnetic resonance imaging (MRI). These tests provide 3-D images and cross-sections of the bladder and kidneys. With a typical CT scan or MRI machine, the child lies on a table that slides inside a tunnel where the images are taken. If the child's infection is complicated or difficult to see in other image tests, a CT scan or MRI can provide clearer, more detailed images to help the doctor understand the problem.

How can urinary tract infections be prevented?
If your child has a normal urinary tract, you can help him or her avoid UTIs by encouraging regular trips to the bathroom. Make sure your child gets enough to drink if infrequent voiding is a problem. Teach your child proper cleaning techniques after using the bathroom to keep