Arlen Angela M, Cooper Christopher S
Departments of Urology and Pediatrics, The University of Iowa, 200 Hawkins Drive, 3RCP, Iowa City, IA, 52242-1089, USA,
Curr Urol Rep. 2015 Sep;16(9):64. doi: 10.1007/s11934-015-0538-2.
Vesicoureteral reflux (VUR) is the abnormal retrograde flow of urine from the bladder into the upper urinary tract. Diagnosis and subsequent management of VUR have become increasingly controversial, with differing opinions over which children should be evaluated for reflux, and when detected, who should undergo treatment. Management goals include prevention of recurrent febrile urinary tract infection (fUTI) and renal injury while minimizing the morbidity of treatment and follow-up. Management options include observation with or without continuous antibiotic prophylaxis and surgical correction via endoscopic, open or laparoscopic/robotic approaches. Management should be individualized and based on patient age, health, risk of subsequent renal injury, clinical course, renal function, and parental preference.
膀胱输尿管反流（VUR）是指尿液从膀胱异常逆行流入上尿路。VUR的诊断及后续治疗一直存在较大争议，对于哪些儿童应接受反流评估，以及反流被检测出后哪些儿童应接受治疗，各方观点不一。治疗目标包括预防复发性发热性尿路感染（fUTI）和肾损伤，同时尽量减少治疗及随访的发病率。治疗方案包括观察（无论是否进行持续抗生素预防）以及通过内镜、开放或腹腔镜/机器人手术进行手术矫正。治疗应因人而异，依据患者年龄、健康状况、后续肾损伤风险、临床病程、肾功能以及家长的偏好来决定。
