儿童排尿性膀胱尿道造影的适应证分析
Analysis of Indications for Voiding Cystography in Children.
作者信息
Kopiczko Natalia, Dzik-Sawczuk Aleksandra, Szwarc Karolina, Czyż Anna, Wasilewska Anna
机构信息
Department of Pediatrics and Nephrology, Medical University of Bialystok, ul. Waszyngtona 17, 15-274 Bialystok, Poland.
出版信息
J Clin Med. 2021 Dec 11;10(24):5809. doi: 10.3390/jcm10245809.
In this study, we report the experience of our center with the prognosis of vesicoureteral reflux, depending on the indications for voiding cystography, during a 12-year period. Retrospective analysis included 4302 children who were analyzed according to the indication for voiding cystography: (1) a febrile urinary tract infection, (2) urinary tract malformations on ultrasonography and (3) lower urinary tract dysfunction. Vesicoureteral reflux was found in 917 patients (21.32%; 24.1% of girls and 17.9% of boys). In group (1), reflux was found in 437/1849 cases (23.63%), group (2) in 324/1388 cases (23.34%) and group (3) in 156/1065 cases (14.65%). A significantly lower prevalence of reflux and its lower degree was found in children from group (3) when compared to other groups ( < 0.01). VURs were confirmed in over 20% of children with urinary tract malformations on ultrasonography or after a febrile urinary tract infection, suggesting the need for voiding cystography in these children. Indications for this examination in children with lower urinary tract dysfunction should be limited.
在本研究中，我们报告了我们中心在12年期间根据排尿性膀胱尿道造影的指征对膀胱输尿管反流预后的经验。回顾性分析纳入了4302名儿童，这些儿童根据排尿性膀胱尿道造影的指征进行分析：（1）发热性尿路感染，（2）超声检查发现的尿路畸形，以及（3）下尿路功能障碍。917名患者发现膀胱输尿管反流（21.32%；女孩为24.1%，男孩为17.9%）。在第（1）组中，437/1849例（23.63%）发现反流，第（2）组中324/1388例（23.34%）发现反流，第（3）组中156/1065例（14.65%）发现反流。与其他组相比，第（3）组儿童的反流患病率显著较低且程度较轻（<0.01）。超声检查发现尿路畸形的儿童或发热性尿路感染后，超过20%的儿童确诊为膀胱输尿管反流，提示这些儿童需要进行排尿性膀胱尿道造影。对于下尿路功能障碍儿童，此项检查的指征应受到限制。
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