Dhabalia J V, Pujari N R, Kumar V, Punia M S, Gokhale A D, Nelivigi G
Department of Urology, Seth GS Medical College and KEM Hospital, Mumbai, India.
Urol Int. 2010;85(1):56-9. doi: 10.1159/000296287. Epub 2010 Mar 12.
To compare the efficacy of the 3-instillation regime with the 9-instillation regime of 1% silver nitrate solution for renal pelvic instillation sclerotherapy in patients with chyluria.
59 Patients with chyluria were prospectively evaluated and randomized into two groups. The study group received 3 instillations (n = 29) while the control group received 9 instillations (n = 30). 1% silver nitrate was used.
In the study group of the 29 patients given sclerotherapy, 28 (96.5%) had complete symptomatic relief while symptoms persisted in 1 (3.44%). None of the patients had hematuria or any other severe complication. In the control group of the 30 patients given sclerotherapy, 29 (96.66%) had complete symptomatic relief while chyluria persisted in 1 (3.33%), 5 patients developed hematuria (16.66%) and 1 patient developed fever with UTI (3.33%). The results of the 3-instillation regime match the results of the more commonly used 9-instillation regime. With this shorter regime, the hospital stay, morbidity and overall complication rate is less and it is more cost effective.
We recommend the 3-instillation regimen in patients with chyluria refractory to conservative treatment.
比较1%硝酸银溶液肾盂灌注硬化疗法中3次灌注方案与9次灌注方案治疗乳糜尿患者的疗效。
对59例乳糜尿患者进行前瞻性评估并随机分为两组。研究组接受3次灌注（n = 29），对照组接受9次灌注（n = 30）。使用1%硝酸银。
在接受硬化疗法的研究组29例患者中，28例（96.5%）症状完全缓解，1例（3.44%）症状持续存在。所有患者均未出现血尿或任何其他严重并发症。在接受硬化疗法的对照组30例患者中，29例（96.66%）症状完全缓解，1例（3.33%）乳糜尿持续存在，5例（16.66%）出现血尿，1例（3.33%）因尿路感染出现发热。3次灌注方案的结果与更常用的9次灌注方案的结果相当。采用这种更短的方案，住院时间、发病率和总体并发症发生率更低，且更具成本效益。
对于保守治疗无效的乳糜尿患者，我们推荐3次灌注方案。
