Leung Ling, Chan Ivy Hau Yee, Chung Patrick Ho Yu, Lan Lawrence Chuen Leung, Tam Paul Kwong Hang, Wong Kenneth Kak Yuen
Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
J Pediatr Surg. 2017 Dec;52(12):2066-2069. doi: 10.1016/j.jpedsurg.2017.08.033. Epub 2017 Sep 4.
We investigated the efficacy of endoscopic-Deflux-injection in treating primary-vesicoureteric-reflux (VUR) and identified factors to predict resolution.
Records of children treated with Deflux for primary-VUR from 1995 to 2016 were reviewed, and outcomes were investigated.
Eighty-eight ureters (35 bilateral, 18 unilateral) in 53 children underwent 124 injections. Thirty-five (66%) patients had single injection (13 unilateral, 22 bilateral). Fifteen (28%), two (37%), and one (2%) patients had two, three, and four injections, respectively. Overall success rate by ureters was 57% after single injection. Complete resolution occurred in 65% of ureters with VUR below grade III, 63% of grade III, 40% of grade IV, and 70% of grade V VUR. Four patients had reimplantation. The median follow up duration was 60months (range 20-216months). Univariate analysis showed that lower VUR grade (p=0.03) and absent renal scars (p=0.04) were statistically significant predictors of resolution. In multivariate analysis, absent renal scars were statistically significant (p=0.01).
We demonstrated efficacy of endoscopic-Deflux-injection as the first line treatment for primary-VUR. Absent renal scar and lower VUR grade were statistically significant predictors of resolution after single injection.
Case-Control / Retrospective Comparative Study.
Level III.
我们研究了内镜下注射Deflux治疗原发性膀胱输尿管反流（VUR）的疗效，并确定了预测反流缓解的因素。
回顾了1995年至2016年接受Deflux治疗原发性VUR的儿童记录，并对治疗结果进行了研究。
53名儿童的88条输尿管（35条双侧，18条单侧）接受了124次注射。35名（66%）患者接受了单次注射（13条单侧，22条双侧）。15名（28%）、2名（37%）和1名（2%）患者分别接受了2次、3次和4次注射。单次注射后输尿管总体成功率为57%。VUR低于III级的输尿管中65%完全缓解，III级的为63%，IV级的为40%，V级VUR的为70%。4名患者接受了再植术。中位随访时间为60个月（范围20 - 216个月）。单因素分析显示，较低的VUR分级（p = 0.03）和无肾瘢痕（p = 0.04）是反流缓解的统计学显著预测因素。多因素分析中，无肾瘢痕具有统计学显著性（p = 0.01）。
我们证明了内镜下注射Deflux作为原发性VUR一线治疗方法的疗效。无肾瘢痕和较低的VUR分级是单次注射后反流缓解的统计学显著预测因素。
病例对照/回顾性比较研究。
III级。
