概括
在儿童中,膀外逆流 (VUR) 具有较低的损伤风险. 目前的证据表明,VUR治疗不会改变这种风险,挑战历史观点.
科学领域:
- 儿科脏病学 儿科脏病学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医学史 医学史 医学史
背景情况:
- 从历史上看,膀外流 (VUR) 被认为是儿童脏痕和损伤的重要危险因素.
- 这种看法导致了对VUR的积极诊断和治疗策略.
研究的目的:
- 重新评估VUR在儿科损伤中的历史理解.
- 分析包括随机对照试验在内的不断发展的研究如何重塑对VUR风险的解释.
- 将目前关于VUR和损伤的研究结果与其历史视角联系起来.
主要方法:
- 审查与VUR相关的历史医学文献和临床实践.
- 对过去15年进行的随机对照试验 (RCT) 结果的分析.
- 综合历史数据与当代证据,以评估与VUR相关的损伤的真实风险.
主要成果:
- 最近的RCT显示,VUR儿童损伤的发生率很低.
- 治疗VUR并没有显著改变损伤的风险.
- 目前的证据表明,VUR的病原性在历史上被高估了.
结论:
- 儿童患VUR损伤的风险比以前认为的要低.
- 目前的证据不支持仅仅为了预防损伤而对VUR进行常规治疗.
- 从历史角度来看,对于理解当前基于证据的VUR管理方法至关重要.
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