Audry G, Bruézière J
Service de Chirurgie Viscérale Pédiatrique, Hôpital Trousseau, Paris.
Ann Urol (Paris). 1992;26(4):227-32.
Vesicoureteral reflux is the principal cause of pyelonephritis in children. Medical treatment is designed to prevent the development of renal parenchymal scars, as these lesions are irreversible and frequently interfere with growth of the kidney. Treatment must therefore be specific and sufficiently prolonged. In infants under the age of 2 years, reflux may resolve in 50% of cases as the ureterovesical junction develops. During this period, treatment consisting of alternating antiseptics should be proposed to prevent the development of pyelonephritis. In all other cases, reflux must be corrected. Two techniques can be proposed at the present time: surgery which gives 98% immediate and permanent good results, using Cohen's technique, and injection of Teflon, which is much less reliable, with risks of distant dissemination, particularly to the brain, and the possibility of developing ureteric stenosis and bladder stones. These problems have led many paediatric urologists to abandon endoscopic treatment.
膀胱输尿管反流是儿童肾盂肾炎的主要病因。医学治疗旨在预防肾实质瘢痕的形成，因为这些病变是不可逆的，且常影响肾脏生长。因此，治疗必须具有针对性且持续足够长的时间。在2岁以下的婴儿中，随着输尿管膀胱连接部的发育，50%的病例中的反流可能会自行缓解。在此期间，应采用交替使用抗菌药物的治疗方法来预防肾盂肾炎的发生。在所有其他情况下，反流都必须得到纠正。目前可采用两种技术：手术，采用科恩技术，可立即取得98%的永久性良好效果；注射特氟龙，其可靠性要低得多，存在远处扩散的风险，尤其是扩散至脑部，并且有可能形成输尿管狭窄和膀胱结石。这些问题导致许多儿科泌尿科医生放弃了内镜治疗。
