Shimada K, Matsui T, Ogino T, Arima M, Mori Y, Ikoma F
Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan.
J Urol. 1988 Nov;140(5 Pt 2):1097-100. doi: 10.1016/s0022-5347(17)41970-7.
We analyzed renal growth and development of renal scars in 754 children with primary and 169 with secondary vesicoureteral reflux. The incidence of a small kidney was 15.5 per cent in the primary and 24.1 per cent in the secondary groups. About three-fourths of the small kidneys remained small from the first examination through followup. Catch-up renal growth was only exceptional. New scars or progression of previous scarring was observed in 7.4 and 30 per cent of the primary and secondary groups, respectively. Factors that promote formation of new scars are high grade vesicoureteral reflux, recurrent urinary tract infections and abnormal bladder function that results in high pressure reflux. We emphasized the importance of precise examination of the lower urinary tract. An early antireflux operation should be performed on children with severe reflux or recurrent urinary tract infections.
我们分析了754例原发性膀胱输尿管反流患儿和169例继发性膀胱输尿管反流患儿的肾脏生长及肾瘢痕发育情况。原发性组小肾发生率为15.5%，继发性组为24.1%。从首次检查到随访，约四分之三的小肾一直保持较小状态。追赶性肾脏生长情况罕见。原发性组和继发性组分别有7.4%和30%观察到新瘢痕形成或既往瘢痕进展。促进新瘢痕形成的因素包括重度膀胱输尿管反流、反复尿路感染以及导致高压反流的膀胱功能异常。我们强调了精确检查下尿路的重要性。对于重度反流或反复尿路感染的患儿应尽早进行抗反流手术。
