UMDNJ-New Jersey Medical School, Department of Urology, 140 Bergen Street, Suite G, Newark, NJ 07103, USA.
J Pediatr Urol. 2013 Dec;9(6 Pt A):955-61. doi: 10.1016/j.jpurol.2013.01.016. Epub 2013 Mar 1.
This study aims to assess pediatric urology practice patterns and factors which influence the use of Deflux(®) in the management of vesicoureteral reflux among pediatric urologists.
A 11-question survey was sent out to 476 pediatric urologists who are members of the Society for Pediatric Urology.
23.7% of pediatric urologists use Deflux(®) as first line therapy for Grade III reflux or higher. The presence of renal scarring is not a deterrent to the use of Deflux(®). 17.7% would use Deflux(®) before a trial of observation with or without chemoprophylaxis. In children who are on observation, 20.3% would perform Deflux(®) when they are at an age considered appropriate for surgery as opposed to continued observation. The majority of pediatric urologists cite Deflux(®) success rates of >70% to >80% for Grades II-III and >50% to >60% for Grades IV-V. 23.3% of respondents indicated that new evidence citing low long-term success rates at one year decreased their use of Deflux(®). 59.8% of respondents indicated they would perform a second injection after an initial failure. Ultrasound and VCUG are used as follow-up in 86.9% and 65.4% respectively after Deflux(®); the majority are performed within the first 3 months, rarely at one year.
The use of Deflux(®) is growing and whether it surpasses open reimplantation and chemoprophylaxis as first-line therapy remains to be seen. With new literature showing lower success rates, long-term follow-up with repeat imaging may be required.
本研究旨在评估小儿泌尿科医生在管理小儿膀胱输尿管反流（VUR）时的实践模式以及影响 Deflux（®）使用的因素。
向小儿泌尿科协会的 476 名成员发送了一份包含 11 个问题的调查。
23.7%的小儿泌尿科医生将 Deflux（®）作为治疗 III 级或更高级别反流的一线治疗方法。存在肾瘢痕不是使用 Deflux（®）的障碍。17.7%的医生会在观察治疗（有或无化学预防）之前使用 Deflux（®）。在接受观察的儿童中，20.3%的医生会在认为适合手术的年龄而不是继续观察时进行 Deflux（®）治疗。大多数小儿泌尿科医生引用 Deflux（®）的成功率为 II-III 级 >70%至>80%，IV-V 级 >50%至>60%。23.3%的受访者表示，新的证据表明一年后长期成功率较低，降低了他们对 Deflux（®）的使用。59.8%的受访者表示，如果初次治疗失败，他们会进行第二次注射。在进行 Deflux（®）治疗后，86.9%和 65.4%分别使用超声和 VCUG 进行随访；大多数在 3 个月内进行，很少在一年后进行。
Deflux（®）的使用正在增加，它是否会超过开放性再植入和化学预防成为一线治疗方法仍有待观察。随着新的文献显示出较低的成功率，可能需要长期随访并重复进行影像学检查。
