对于尿路感染的幼儿在住院期间空白囊尿回路图的全国趋势
Elizabeth W Pingree1, Beth D Harper1, Shanshan Liu2
1Division of General Pediatrics.
Hospital pediatrics
|September 6, 2023
概括
在指导方针发布后,尿路感染 (UTI) 的婴儿中,排泄囊尿表图 (VCUG) 的使用减少了. 这一趋势在指导方针发布后继续下去,膀外流的诊断和手术减少了.
科学领域:
- 儿科脏病学 儿科脏病学
- 诊断成像 诊断成像 诊断成像
- 传染性疾病 传染性疾病
背景情况:
- 美国儿科学会在2011年推不要在2-24个月的婴儿中进行例行空白囊尿表图 (VCUG),因为他们有发烧性尿路感染 (UTI).
- 这一指导方针对较年轻婴儿 (<2个月) 的VCUG使用的影响尚不清楚.
研究的目的:
- 分析诊断出尿路感染的0至2个月龄的婴儿住院期间VCUG表现的趋势.
- 为了比较2011年AAP指南之前和之后的VCUG率.
主要方法:
- 从2008年至2019年间,在38个机构中,对住院患有尿路感染的婴儿 (0-2个月) 进行了回顾性队列研究.
- 使用零碎混合效应物流回归来比较指南 (2008-2011) 之前和指南 (2012-2019) 之后的时期.
- 评估结果包括复发性尿路感染,膀外流 (VUR) 诊断和抗VUR程序.
主要成果:
- 在指导方针前和指导方针后的两段时间里,VCUG的利用率均表现出约20%的持续年均下降.
- 与指导方针之前的时期相比,在指导方针后的VCUG表现趋势中没有发现显著差异.
- 在指南发布后,VUR诊断和抗VUR手术的执行率显著下降,但复发性尿路感染率没有变化.
结论:
- 在小婴儿因尿路感染住院期间,VCUG的使用在过去十年中下降了.
- 观察到的VCUG业绩下降在指南发布后继续.
- 进一步的研究是必要的,以建立最佳的成像策略,为这个患者群体.
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