Preston A A
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1088.
Curr Opin Pediatr. 1994 Apr;6(2):178-82. doi: 10.1097/00008480-199404000-00010.
The relationship of urinary tract infection and vesicoureteric reflux with the potential for renal scarring and serious sequelae is well known. Evaluation of the child with urinary tract infection and identification of those at risk for infection are of paramount importance. With early diagnosis and early institution of proper therapy, the likelihood of renal scarring can be significantly reduced, and thus outcome can be improved. This review points to the controversies surrounding the ability to accurately distinguish between upper and lower tract urinary infection, and whether this distinction is important in the care of the child with urinary infection. Vesicoureteric reflux as a risk factor is discussed. Ultrasound examination and voiding cystourethrogram or radionuclide cystogram are generally recommended for evaluating the lower urinary tract of infants and preschool children who have urinary tract infection. The role of dimercaptosuccinic acid scanning in evaluating the upper tract is debated.
尿路感染和膀胱输尿管反流与肾瘢痕形成及严重后遗症风险之间的关系是众所周知的。对患有尿路感染的儿童进行评估并确定那些有感染风险的儿童至关重要。通过早期诊断和尽早开始适当治疗，可显著降低肾瘢痕形成的可能性，从而改善预后。本综述指出了围绕准确区分上尿路和下尿路感染的能力以及这种区分在尿路感染儿童护理中是否重要的争议。讨论了膀胱输尿管反流作为一个风险因素。对于患有尿路感染的婴儿和学龄前儿童，一般建议进行超声检查和排尿性膀胱尿道造影或放射性核素膀胱造影以评估下尿路。二巯基丁二酸扫描在评估上尿路中的作用存在争议。
