泌尿男生殖系统感染精要.ppt

泌尿男生殖系统感染 Genitalia and urinary tract infection of male 一、分类(Classification) 一、非特异感染 the most common bacillus:G- 大肠杆菌（60-80%），副大肠杆菌，变形杆菌，克雷白菌 G+ :金黄色葡萄球菌，表皮葡萄球菌，链球菌，粪链球菌 二、特异性感染 tuberculosis，gonococcus 二、发病机制（mechanism） 一、感染因素（infection factor) 细菌黏附于尿路黏膜（Bacterial adhesin ） 输尿管蠕动减弱（ squirm of urethral ） 二、宿主防御机制（resist power of host） PH Osmosis High concentration of urea organic acid immunoreaction(IgA,IgG) 三、诱发因素 Reduce of immune power with human Obstruction of urinary tract Hospital-acquired infection factor 四、感染途径（routes of infection） 上行性感染(ascending route) 血行性感染(hematogenous route) 淋巴感染(lymphatic route) 直接蔓延感染(extend invade route) 五、诊断（ diagnosis） History (pain,frequency,urgency,dysuria) Urine collection suprapubic aspiration urethral catheterization segmented voided urine specimens Urinalysis ：≥105,infection;104,pollution Urine culture 五、诊断（ diagnosis） Localization kideny,prestate and urethra Imaging techniques Uroflowmetry 六、急性膀胱炎(acute cystitis) Incidence 25% to 30% of women between the ages of 20 and 40 Ascending route Nosogenetic bacteria 六、急性膀胱炎(acute cystitis) Clinical presentation dysuria frequency urgency suprapubic or lower abdominal pain hematuria 六、急性膀胱炎(acute cystitis) Diagnosis 1.History 2.Laboratory examitation:urinary routine 3.Differential diagnosis vaginitis urethral infection 六、急性膀胱炎(acute cystitis) Management Antimicrobial selection Intake with large volume water 七、慢性前列腺炎(chronic prostatitis) Classification acute bacterial prostatitis chronic bacterial prostatitis nonbacterial prostatitis prostatodynia 七、慢性前列腺炎(chronic prostatitis) Etiology and pathogenesis 1.ascending urethral infection or reflux of urine into proststic duct 2.gram-negative bacteria 3. NBP 4.prostatodynia 七、慢性前列腺炎(chronic prostatitis) Clinical presentation 1.Irritative symptoms 2.Pain (vesical,prostate,penile,testis) 3.Erectile dysfunction 4.strain 七、慢性前列腺炎(chronic prost