Merguerian P A, McLorie G A, Churchill B M, McKenna P H, Khoury A E
Section of Urology (Department of Surgery), Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756.
J Urol. 1992 Nov;148(5):1499-503. doi: 10.1016/s0022-5347(17)36949-5.
A retrospective statistical analysis with a minimum followup of 10 years was done on 102 patients who presented in early childhood with posterior urethral valves. All patients were treated with initial bladder drainage. Factors correlating with the development of renal failure were evaluated. No patient with a normal kidney on 1 side had renal failure. Calculated glomerular filtration rate was significantly higher in patients who retained adequate renal function (80.7 +/- 17.8 ml. per minute per 1.73 m.2), as compared with those who had renal failure (18.6 +/- 9.6 ml. per minute per 1.73 m.2). Patients with renal failure also had a significantly higher serum creatinine level at stabilization (2.0 +/- 0.8 mg./dl.) than those who had adequate renal function (0.5 +/- 0.2 mg./dl.). The presence of bilateral high grade vesicoureteral reflux, hydronephrosis and nonfunction was significantly higher in patients with renal failure. Patient age at presentation was not a significant factor. These data represent a guideline for the prognosis and management protocols of infants with dilated upper urinary tracts and posterior urethral valves.
对102例儿童期早期出现后尿道瓣膜的患者进行了一项回顾性统计分析，随访时间至少为10年。所有患者均接受了初始膀胱引流治疗。评估了与肾衰竭发生相关的因素。单侧肾脏正常的患者无肾衰竭。保留足够肾功能的患者计算的肾小球滤过率（每分钟每1.73平方米80.7±17.8毫升）显著高于肾衰竭患者（每分钟每1.73平方米18.6±9.6毫升）。肾衰竭患者在病情稳定时的血清肌酐水平（2.0±0.8毫克/分升）也显著高于肾功能正常的患者（0.5±0.2毫克/分升）。肾衰竭患者双侧高级别膀胱输尿管反流、肾积水和肾功能丧失的发生率显著更高。就诊时的患者年龄不是一个显著因素。这些数据为患有上尿路扩张和后尿道瓣膜的婴儿的预后和管理方案提供了指导。
