儿童青少年原发性膀胱输尿管反流的临床过程:对958例患者的回顾性研究

A. Madani, Y. Ravanshad, A. Azarfar, N. Hajizadeh, N. Ataei, Zahra Adl, Zahra Pournasiri, S. Bagheri, S. Ravanshad, Elham Samazghandi
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引用次数: 1

摘要

摘要介绍。膀胱输尿管反流(VUR)是最常见的儿科泌尿系统异常,由于它可导致尿路感染和肾瘢痕,因此是儿科肾脏病学的一个重要问题。方法。对伊朗德黑兰儿童医疗中心958例原发性VUR患者进行回顾性随访。研究纳入了原发性膀胱输尿管反流患儿,研究了以下参数:年龄、性别、临床表现、VUR分级、超声检查结果、DMSA变化、治疗方式(内科、外科或内窥镜)和对治疗的反应、高血压(存在/不存在)、尿路感染复发和在接受药物治疗的患者中出现新的肾疤痕。结果。VUR在女孩中更为普遍。超声检查在许多病例中无法检测到VUR。肾瘢痕的存在与反流程度密切相关。医疗管理在相当比例的患者中是有效的,他们经历了反流的完全解决。对于VUR程度较低的人来说尤其如此。17.6%的患者在随访中出现新的肾疤痕,并伴有较高程度的VUR。高血压合并突发性尿路感染在我们的患者中并不常见。结论。医学管理,即使用预防性抗生素预防尿路感染,在许多VUR病例中是有效的,特别是在VUR程度较低的病例中。手术和内窥镜手术必须保留给对保守治疗无反应的高度VUR患者或可能产生新疤痕的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Course of Children and Adolescents with Primary Vesicoureteral Reflux: A retrospective study of 958 patients
Abstract Introduction. Vesicoureteral reflux (VUR) is the most common pediatric urologic abnormality and since it can predispose to urinary tract infection and resultant kidney scar it is an important issue in pediatric nephrourology. Methods. A retrospective chart review and follow-up of 958 patients with primary VUR was performed in the Children’s Medical Center, Tehran, Iran. Children with primary vesicoureteral reflux were included in the study and these parameters were studied: age, sex, clinical presentation, VUR grade, sonographic findings, DMSA changes, treatment modality (medical, surgical or endoscopic) and response to treatment, hypertension (presence/absence), urinary tract infection recurrence and development of new kidney scars in patients under medical treatment. Results. VUR was more prevalent in girls. Sonography was unable to detect VUR in many cases. Presence of renal scars was strongly associated with degree of reflux. Medical management was effective in a substantial percentage of patients and they experienced full resolution of reflux. This was especially true for lower degrees of VUR. 17.6% of patients developed new kidney scars on followup which was associated with higher degrees of VUR. Hypertension and breakthrough urinary tract infection was an uncommon finding in our patients. Conclusion. Medical management, which means using prophylactic antibiotics for prevention of urinary tract infection, is effective in many cases of VUR especially in cases with lower degrees of VUR. Surgical and endoscopic procedures must be reserved for patients with higher degrees of VUR unresponsive to conservative management or in whom new scars may develop.
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