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婴儿尿路感染与排尿性膀胱尿道造影的时机。

Infantile urinary tract infection and timing of micturating cystourethrogram.

机构信息

Department of Paediatric Urology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield S10 2TH, UK.

出版信息

J Pediatr Urol. 2010 Dec;6(6):582-4. doi: 10.1016/j.jpurol.2010.01.008. Epub 2010 Feb 25.

Abstract

OBJECTIVE

The investigation of infantile febrile urinary tract infection (UTI) is still a subject of debate and controversy. To evaluate for vesicoureteric reflux (VUR) most authorities recommend a micturating cystourethrogram (MCUG) to be performed at least 4 weeks after UTI to avoid false positive.

PATIENTS AND METHODS

At a tertiary centre for paediatric specialities, information on 427 infants who had undergone MCUG following a first febrile UTI was prospectively recorded and their case notes reviewed. The infants were divided into two groups: Group A (117) with MCUG performed less than 4 weeks from UTI diagnosis and Group B (310) with MCUG after at least 8 weeks from diagnosis.

RESULTS

Of the 427 children, VUR was detected in 33% of those for whom MCUG was performed less than 4 weeks after UTI diagnosis and in 24% of those for whom it was performed at least 8 weeks after diagnosis.

CONCLUSION

Neither the prevalence nor the grade of VUR in infants with a first episode of UTI is influenced by the timing of the MCUG following diagnosis. We therefore suggest that it is better to perform an MCUG as soon as possible, provided inflammation has subsided.

摘要

目的

婴儿发热性尿路感染(UTI)的调查仍然存在争议。为了评估膀胱输尿管反流(VUR),大多数权威机构建议在 UTI 后至少 4 周进行排尿性膀胱尿道造影(MCUG),以避免假阳性。

患者和方法

在一家儿科专科医院,前瞻性地记录了 427 名首次发热性 UTI 后接受 MCUG 的婴儿的信息,并对其病历进行了回顾。将婴儿分为两组:A 组(117 例)在 UTI 诊断后 4 周内进行 MCUG,B 组(310 例)在诊断后至少 8 周进行 MCUG。

结果

在进行 MCUG 的 427 名儿童中,A 组(117 例)在 UTI 诊断后 4 周内进行 MCUG 的患儿中,VUR 的检出率为 33%,B 组(310 例)在诊断后至少 8 周进行 MCUG 的患儿中,VUR 的检出率为 24%。

结论

首次发生 UTI 的婴儿中,MCUG 检查的时间既不影响 VUR 的发生率,也不影响其严重程度。因此,我们建议只要炎症消退,就尽快进行 MCUG。

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