Afshar K, Macneily A E
Department of Urologic Sciences, University of British Columbia and BC Children's Hospital, Vancouver BC, Canada V5Z 1M9. K. Afshar,
Adv Urol. 2008;2008:295492. doi: 10.1155/2008/295492.
There are many ongoing controversies surrounding vesicoureteral reflux (VUR). These include variable aspects of this common congenital anomaly. Lack of evidence-based recommendations has prolonged the debate. Systematic reviews (SRs) and meta-analysis (MA) are considered high-level evidence. The purpose of this review article is to summarize and critically appraise the available SR/MA pertaining to VUR. We also discuss the strength and pitfalls of SR/MA in general. A thorough literature search identified 9 SRs/MAs relevant to VUR. Both authors critically reviewed these articles for contents and methodological issues. There are many concerns about the quality of the studies included in these SRs. Clinical heterogeneity stemming from different patient selection criteria, interventions, and outcome definitions is a major issue. In spite of major advances in understanding different aspects of VUR in the last few decades, there is a paucity of randomized controlled trials in this field.
围绕膀胱输尿管反流（VUR）存在许多持续的争议。这些争议包括这种常见先天性异常的多个方面。缺乏基于证据的建议延长了争论。系统评价（SRs）和荟萃分析（MA）被视为高级证据。这篇综述文章的目的是总结并批判性地评估与VUR相关的现有SR/MA。我们还将总体讨论SR/MA的优势和缺陷。全面的文献检索确定了9篇与VUR相关的SRs/MAs。两位作者对这些文章的内容和方法学问题进行了批判性审查。人们对这些SRs中纳入的研究质量存在诸多担忧。不同的患者选择标准、干预措施和结局定义导致的临床异质性是一个主要问题。尽管在过去几十年中对VUR不同方面的理解取得了重大进展，但该领域的随机对照试验仍然匮乏。
