上海交通大学医学院儿科学临床医学八年一贯制泌尿系统.pptxVIP

urinary system 上海交通大学医学院附属新华医院儿内科教研室 卫敏江 urinary system Urinary system includes the kidney、ureter、bladder and urethra . The kidney is an important excretory organ , also , it is an essential adjuster and endocrine organ to maintain a precise balance of internal environment .anatomical characterneonate larger，inmature，small glomerulus ，short tubuleinfant Ureter is much longer and incurvater, tube muscles and elastic fibers are dysontogenesis . Ureter close to the bladder is straighter and shorter, it is poor to prevent urine reverse flow. female infant has a shorter urethra? ,but male infant often has capistration physiologic character ◆ glomerular filtration commences in the metanephric kidney at about 9 to 12 weeks of gestation， the full complement of nephrons is present at 36 weeks of gestation . ◆ low reserve capacity ，inmature regulatory mechanism，easy to dysfunction? 。◆ the renal function(calculated by body weight or body surface area) reaches a value comparable to adult at 1 to 2 years of age. glomerular filtration rate ◆neonate the first week of birth : glomerular filtration↓ 2 –year-old: adult level ◆pathology extra moisture?and solute?can not excretion in time →edema the reabsorption and the excretory function of renal tubule ◆glomerulotubular balance neonate has already possess glomerulotubular balance ，but inmature。 ◆ amino acid?/glucose term infant : normal reabsorption capacity premature infant: renal tubule function deficiency， glucose threshold ↓→glucosuria (reabsorpt glucose ↓） natrium neonate aldosterone ↑→natrium positive balance ◆ glomerular filtration rate ↓ → natrium load↑ → natriume excretion ↓ →edema◆ infant of low-birth weight natriume duction ↑ →if natriume intake ↓（3mmol/kg/d）→hyponatremia →shock or convulsion potassium because Na-K-ATP enzyme system of renal tubules epithelium is inmature， neonate potassium excretion↓in 10 ays→hyperkalemia tendency。acid-base balance ◆kidney→excret H＋、reabsorb HCO3－→ acid-b