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[小儿膀胱输尿管反流的临床研究]

[Clinical study in infants with vesicoureteral reflux].

作者信息

Kunikata S, Kohri K, Akiyama T

机构信息

Department of Urology, Kinki University Medical School.

出版信息

Hinyokika Kiyo. 1991 Nov;37(11):1407-13.

PMID:1767768
Abstract

A clinical study was performed on 52 infants up to 2 years old with vesicoureteral reflux. We treated 12 of them conservatively. Half of them dropped out within 1 year. It was very difficult to follow up the infants over a long time in the conservative treatment group. As a result of the conservative treatment, reflux disappeared spontaneously in only 2 infants. Forty infants underwent antireflux operations. The reflux disappeared in all cases. However, we injured the peritoneum in 2 cases when the Politano-Leadbetter method was applied. A modified Politano-Leadbetter method was adopted because of the peritoneum injury. As an antireflux operation on infants, the modified Politano-Leadbetter method is desirable. Renal function and growth were studied. Renal function was assessed with 99m-Tc-DTPA renograms. Renal ratio was evaluated by intravenous pyelography. The function of refluxing kidneys Severely damaged was not improved after the antireflux operations. The small kidneys with a high grade or the atrophic kidneys did not demonstrate normalization of renal growth after antireflux operations. In conclusion, it is important to detect the reflux at the early infant stage and perform the antireflux operation at an early stage in the case of high grade or renal impairment.

摘要

对52名2岁以下患有膀胱输尿管反流的婴儿进行了一项临床研究。我们对其中12名婴儿进行了保守治疗。其中一半在1年内退出。在保守治疗组中,很难对婴儿进行长期随访。保守治疗的结果是,只有2名婴儿的反流自发消失。40名婴儿接受了抗反流手术。所有病例的反流均消失。然而,在应用波利塔诺-利德贝特方法时,我们有2例损伤了腹膜。由于腹膜损伤,采用了改良的波利塔诺-利德贝特方法。作为婴儿的抗反流手术,改良的波利塔诺-利德贝特方法是可取的。研究了肾功能和生长情况。用99m锝-二巯基丁二酸肾图评估肾功能。通过静脉肾盂造影评估肾比率。抗反流手术后,严重受损的反流肾脏的功能没有改善。高等级的小肾脏或萎缩性肾脏在抗反流手术后没有显示出肾脏生长的正常化。总之,在婴儿早期检测反流并在高等级或肾功能损害的情况下尽早进行抗反流手术很重要。

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