Dvorácek J, Kocvara R, Kriz J
Klinik für Urologie, Karls-Universität Prag.
Z Urol Nephrol. 1987 Aug;80(8):467-75.
During 8 years in the department of paediatric urology of the Clinic of Urology of the Charles University Prague 267 children with a vesicoureteral reflux (VUR) aged between 6 months and 15 years were operated. The sex ratio girls to boys was 4.5 to 1.0. At 89% an infection of the urinary tract was simultaneously present. On an average first symptoms appeared at the age of 3 1/2 years. The operative therapy was performed at the of 6. 221 children with 340 reflux units underwent an after examination 3 to 12 months after operation. Most frequent were the degrees of reflux II and III with altogether 82%. 255 vesicoureteral refluxes were primary refluxes and 85 secondary ones. 208 reflux ureters were modified after Politano-Leadbetter, 105 modified after Gil-Vernet, 17 were treated in form of a pyeloureter anastomosis and 10 by means of nephroureterectomy. A persisting post-operative infection of the urinary tract was existing in 14.5% after 3 months and in 8.8% after 1 year. Implantation stenoses appeared in 2.4% and were successfully reoperated. Altogether the healing of the reflux was successful in 96.4%. An early operative therapy and in refluxes of second and third degree the modified method according Gil-Vernet are recommended.
在布拉格查理大学泌尿外科诊所的小儿泌尿外科工作的8年期间，对267例年龄在6个月至15岁之间的膀胱输尿管反流（VUR）患儿进行了手术。女孩与男孩的性别比为4.5比1.0。89%的患儿同时存在尿路感染。平均首次症状出现在3.5岁。手术治疗在6岁时进行。221例患儿的340个反流单位在术后3至12个月接受了复查。最常见的反流程度为II度和III度，共占82%。255例膀胱输尿管反流为原发性反流，85例为继发性反流。208条反流输尿管采用波利塔诺-利德贝特法进行了改良，105条采用吉尔-韦尔内法进行了改良，17条采用肾盂输尿管吻合术治疗，10条采用肾输尿管切除术治疗。术后3个月时，14.5%的患儿存在持续性尿路感染，1年后为8.8%。植入狭窄发生率为2.4%，并成功进行了再次手术。总体而言，反流愈合成功率为96.4%。建议早期进行手术治疗，对于II度和III度反流，采用吉尔-韦尔内改良法。
