Polmear A F, Kenney I J, Barnard S A
Academic Unit of Primary Care, Trafford Centre for Medical Education and Research, University of Sussex, Brighton.
Br J Gen Pract. 1999 Feb;49(439):115-7.
All children with urinary tract infections (UTIs) should undergo imaging of the urinary tract. The Royal College of Radiologists currently recommends that such children should be referred to a paediatric specialist prior to imaging.
To investigate whether direct referral of such children by general practitioners (GPs) for imaging offers advantages over the traditional approach.
Information on 100 children with UTIs, who were referred direct for imaging by GPs according to an agreed protocol, was compared with information on 100 children with UTIs referred initially to paediatric specialists.
Protocol-guided direct referral resulted in less delay prior to imaging, no evidence of inappropriate referral (as judged by urinalysis and yield from imaging), greater consistency of follow-up arrangements, and a considerable saving in outpatient department (OPD) appointments. There was no increase in the overall number of referrals for imaging.
Given agreed protocols, there is no basis for current recommendations that GPs should not refer children with UTIs for imaging without a prior paediatric opinion.
所有患有尿路感染（UTIs）的儿童都应接受泌尿系统成像检查。英国皇家放射科医师学院目前建议，此类儿童在进行成像检查前应转诊至儿科专科医生处。
调查全科医生（GPs）直接转诊此类儿童进行成像检查是否比传统方法更具优势。
将100名根据商定方案由全科医生直接转诊进行成像检查的尿路感染儿童的信息，与100名最初转诊至儿科专科医生处的尿路感染儿童的信息进行比较。
方案指导下的直接转诊减少了成像检查前的延迟，没有不适当转诊的迹象（根据尿液分析和成像检查结果判断），随访安排更加一致，并且在门诊部（OPD）预约方面节省了大量费用。成像检查的转诊总数没有增加。
鉴于有商定的方案，目前关于全科医生在没有事先征求儿科意见的情况下不应转诊患有尿路感染的儿童进行成像检查的建议没有依据。
