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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 郭嘉政 | 脊髓損傷患者泌尿科的追蹤治療-系統性文獻回顧 | 2012/5/30 上午 09:46:30 | 0 |
| 原 文 | 題 目 | Systematic Review of Urological Followup After Spinal Cord Injury |
| 作 者 | Anne P. Cameron,* Gianna M. Rodriguez and Katherine G. Schomer From the Departments of Urology (APC) and Physical Medicine and Rehabilitation (GMR), University of Michigan, Ann Arbor, Michigan, and University of Washington (KGS), Seattle, Washington | |
| 出 處 | Journal of Urology Vol. 187, 391-397, | |
| 出版日期 | February 2012 | |
| 評 論 | 脊髓損傷患者泌尿系統的追蹤診治不是一件輕鬆的工作. 作者以實證醫學的角度 , 系統性文獻回顧從 385篇摘要精選出 50篇 符合 UTI , Urinary Tract Stones , Urodynamics , Bladder Cancer , Renal scan等研討主題者, 以American Academy of Neurology 2004 guidelines.的標準, 綜合評分統計分析 , 試圖達成較佳的追蹤治療共識. 結論是只有 renal ultrasound. 達到追蹤治療共識的推薦標準.似乎這就是嚴謹的實證醫學.期待各方先進们能進一步探討. | |
| abstract |
Purpose: There is no consensus on the appropriate urological followup of individuals after spinal cord injury but it is well known that they are at risk for renal deterioration, bladder cancer and stones. We systematically reviewed the literature to evaluate evidence of urological screening in this population. Materials and Methods: We reviewed 385 abstracts, of which 50 met studyinclusion criteria.We rated evidence using American Academy of Neurology 2004 guidelines. Results: A total of 12 articles evaluated urinary tract infection screening. Patient reported symptoms used to predict urinary tract infection yielded mixed results and urine dipstick testing had the same accuracy as microscopy. Routine urine culture was unnecessary in healthy, asymptomatic individuals with normal urinalysis. Urodynamics probably must be done periodically (6 articles) but there was no information on frequency. In 11 articles ultrasound was recommended as a useful, noninvasive and possibly cost-effective screening method. Renal scan was a good method for further testing, especially if ultrasound was positive (11articles). Evidence was sufficient (11 articles) to recommend ultrasound of the urinary tract to detect urinary tract stones with good sensitivity but not plain x-ray of the kidneys, ureters and bladder (2 articles). There was insufficient evidence to recommend urine markers or cytology for bladder cancer screening (9articles). Conclusions: Based on this review no definitive recommendations for screening can be made except routine renal ultrasound. Urodynamics are an important partof screening but the frequency is unclear. The optimum bladder cancer screening method has not been defined |
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