Cavanagh P M, Sherwood T
Br J Urol. 1983 Apr;55(2):217-9. doi: 10.1111/j.1464-410x.1983.tb06560.x.
We report on 62 children referred for a first micturating cystourethrogram (MCU) and intravenous urogram (IVU) because of suspected or proven urinary tract infection (UTI). The study represents 1 year's experience of a district hospital, but excludes children below the age of 6 months and those with a diagnosis of urinary drainage anomaly. The IVU proved a good predictor of gross vesicoureteric reflux, which affected 11 children, all with suspect IVUs. Lesser grades of reflux can occur in the presence of a normal IVU but are unlikely to damage the kidney. They can be managed by treating symptoms of infection rather than by the need to protect nephrons. In our study a suspect IVU implied a 79% chance of gross reflux, and a normal IVU excluded such reflux. It is suggested that children over 6 months of age with a clinically important infection should be spared an MCU unless the IVU is abnormal, or troublesome infections recur.
我们报告了62名因疑似或确诊尿路感染（UTI）而接受首次排尿性膀胱尿道造影（MCU）和静脉肾盂造影（IVU）检查的儿童。该研究代表了一家地区医院一年的经验，但不包括6个月以下的儿童以及诊断为尿路引流异常的儿童。静脉肾盂造影被证明是严重膀胱输尿管反流的良好预测指标，有11名儿童出现了这种反流，他们的静脉肾盂造影结果均可疑。在静脉肾盂造影正常的情况下也可能出现较轻程度的反流，但不太可能损害肾脏。可以通过治疗感染症状来处理，而无需保护肾单位。在我们的研究中，可疑的静脉肾盂造影意味着有79%的可能性出现严重反流，而正常的静脉肾盂造影则排除了这种反流。建议6个月以上患有具有临床意义感染的儿童，除非静脉肾盂造影异常或反复出现麻烦的感染，否则应避免进行排尿性膀胱尿道造影检查。
