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Craig Authement1,2, Poyyapakkam Srivaths2
1Division of Pediatric Nephrology, Department of Pediatrics, Baylor College of Medicine.
Pediatrics
|January 26, 2026
概括
美国儿科学会 (AAP) 的指导方针减少了在儿童发烧性尿路感染 (UTI) 时使用排泄性囊尿表图 (VCUG). 目前的数据表明,尽管有指导退休,但这种下降并没有导致伤害.
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
- 临床实践指南 临床实践指南
背景情况:
- 2011年美国儿科学会 (AAP) 的指导方针改变了对儿科发烧性尿路感染 (UTI) 的成像建议.
- 排空囊-尿路图 (VCUG) 被取消作为一线研究的重视,膀超声波 (RBUS) 成为首选的初始成像模式.
- 该指南旨在减少儿童的辐射暴露和不适,同时管理高度膀-尿道逆流 (VUR) 或阻塞性尿路病的风险.
研究的目的:
- 根据2011年美国医学会关于儿童发烧性尿路感染 (UTI) 的指南,评估减少排泄囊尿表图 (VCUG) 使用的影响.
- 为了确定VCUG的使用减少是否导致任何不良结果或对儿科患者的伤害.
- 在2021年指南退休后,评估儿童尿路感染成像实践的现状.
主要方法:
- 在2011年美国儿科学会 (AAP) 针对发烧性尿路感染 (UTI) 的指导方针之后,对清除囊囊尿路图 (VCUG) 使用趋势的分析.
- 对临床结果和与儿童群体中VCUG使用量减少相关的潜在危害的审查.
- 检查在指南后的时代当前的成像实践,考虑到指南的退休.
主要成果:
- 2011年AAP指南的实施导致了儿童发烧性尿路感染 (UTI) 清空囊尿路图 (VCUG) 的使用大幅减少.
- 尽管VCUGs的减少,但现有的数据并不表明与高度膀-尿道逆流 (VUR) 或阻塞性尿路病变相关的伤害或错过诊断的增加.
- 即使在指南退休后,接受VCUG的儿童比例仍然很低,这表明临床实践的持久转变.
结论:
- 在儿童发烧性尿路感染 (UTI) 后,按照2011年AAP指南的建议,从常规的排泄囊尿表图 (VCUG) 转移似乎是安全的.
- 减少VCUG的使用没有明显导致危害增加,支持指南的平衡诊断产量与程序风险的方法.
- 持续监测成像实践和儿科尿道感染患者的结果是合理的,特别是在指南退休后.
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