Seleem Mohammed M, Eliwa Ahmed M, Elsayed Ehab R, Desouky Hamdy, El Galaly Hazem, Abdelwahab Khalid, Khalil Salem, El Adl Mahmoud
Department of Urology, Faculty of Medicine, Zagazig University, Egypt.
Arab J Urol. 2016 Apr 26;14(2):131-5. doi: 10.1016/j.aju.2016.01.006. eCollection 2016 Jun.
To compare the safety, efficacy and complications of single vs multiple instillations of povidone iodine (PI) and urographin as a sclerosing agent in the treatment of chyluria.
The study included 58 patients diagnosed with chyluria between March 2006 and January 2013. The inclusion criteria were either severe attacks of chyluria or patients with mild-to-moderate chyluria who had failed conservative treatment. The patients were randomly allocated to one of two groups: those in Group A had a single instillation of a combination of PI 0.2% plus the contrast-agent urographin 76%, while those in Group B had multiple instillations of the same combination twice daily for 3 successive days.
The mean (SD) age of the patients in Groups A and B was 38.22 (10.67) and 37.9 (10.86) years, respectively. Chyluria was severe in eight patients (14.8%), moderate in 25 (46.3%) and mild in 21 (38.9%). The success rate in Group A (single instillation) was 85.2% and in Group B (multiple instillation) was 88.9%. The recurrence rate in Group A was 14.8% with a disease-free duration (DFD) of 4-15 weeks, while in group B it was 11.1% with a DFD of 6-18 weeks.
There was no significant difference between a single instillation of a combination of PI 0.2% and urographin 76% as a sclerosing agent in the treatment of chyluria and multiple instillations. However, the single instillation protocol is more cost effective with a shorter hospital stay.
比较单用与多次灌注聚维酮碘（PI）和泛影葡胺作为硬化剂治疗乳糜尿的安全性、疗效及并发症。
本研究纳入了2006年3月至2013年1月期间诊断为乳糜尿的58例患者。纳入标准为乳糜尿严重发作或保守治疗失败的轻至中度乳糜尿患者。患者被随机分为两组：A组患者单次灌注0.2%PI与76%造影剂泛影葡胺的合剂，而B组患者连续3天每天两次多次灌注相同合剂。
A组和B组患者的平均（标准差）年龄分别为38.22（10.67）岁和37.9（10.86）岁。8例患者（14.8%）乳糜尿严重，25例（46.3%）中度，21例（38.9%）轻度。A组（单次灌注）成功率为85.2%，B组（多次灌注）为88.9%。A组复发率为14.8%，无病生存期（DFD）为4 - 15周，而B组复发率为11.1%，DFD为6 - 18周。
单次灌注0.2%PI与76%泛影葡胺合剂作为硬化剂治疗乳糜尿与多次灌注之间无显著差异。然而，单次灌注方案更具成本效益，住院时间更短。
