关键词: 膀胱输尿管反流；　尿路感染；　神经源性膀胱；　预后

Abstract: 　Objective　To retrospectively analyze the etiology, renal damage and prognosis of children with ureteral vesical reflux (VUR). Methods　Children hospitalized in Wuxi Children's Hospital from January 2012 to December 2017 due to febrile urinary tract infection were enrolled, and a total of 90 cases of VUR confirmed by excretory urography (MCU) were selected, reflux level, reflux cause, renal scar formation and prognosis were analyzed. Results　In 90 cases (41 boys, 49 girls, median age 0.90 years), 46 cases had bilateral reflux and 4 case had neurogenic bladder in children with bilateral reflux. Among 90 cases, 51 cases (56.6%) were infants under one year old, and the proportion of boys (68.2%) was higher than that of girls (46.9%). With the increase of age, the incidence of VUR in girls was significantly higher than that in boys (1 case of boys over five years old, 9 cases of girls). The proportion of severe regurgitation in infants was 43.2%, and the proportion of severe regurgitation in more than 1 years old was 52.7%. Of the 90 cases, 6 cases were treated by operation and the remaining 84 cases were treated by conservative treatment, of which 48 cases were followed up with regular urine routine examination, urine culture, 99mTc-dimercaptosuccinic acid (DMSA) and MCU. Of them, 15 cases were with urinary tract infection recurrence, and 5 cases were transferred to surgical treatment in the follow-up process due to renal scar or glomerular filtration rate decline. Among 25 cases in one year after the review of MCU, 1 case was aggravated by reflux, 12 cases remained unchanged, 5 cases were relieved, and 7 cases disappeared. Renal scar: 8 cases of DMSA were firstly found renal shape reduced and renal scar formation, 10 cases during follow-up were found with moderate and severe regurgitation. Conclusion　Children with fever should be alert to urinary tract infection. Children with infantile urinary tract infection, especially for boys, attention should be paid to the existence of VUR. Each phase examination (renal static, renal dynamics, MCU, etc.) can not be replaced by each other. For children with bilateral VUR, it is necessary to determine whether it is neurogenic bladder or associated with other malformations.

Key words: vesical ureteral reflux;　urinary tract infection;　neurogenic bladder;　prognosis.