Sidi A A, Peng W, Gonzalez R
J Urol. 1986 Jul;136(1 Pt 2):329-31. doi: 10.1016/s0022-5347(17)44856-7.
A total of 58 children with myelodysplasia underwent radiographic and cystometric evaluation and were followed periodically for an average of 58 months. Of this group 30 (52 per cent) demonstrated vesicoureteral reflux, including 16 with low grade and 14 with high grade reflux. In 6 children low grade vesicoureteral reflux resolved with prophylactic antibacterials only, while decompressive treatment was required in 6, antireflux surgery was required in 2 and 2 were lost to followup. Despite adequate decompressive treatment 12 of the 14 children with high grade vesicoureteral reflux required an antireflux operation and 2 were lost to followup. Among those who underwent an operation there has been no recurrent reflux but 3 children have shown evidence of upper urinary tract deterioration. We describe our current approach to the treatment of vesicoureteral reflux in children with neurogenic bladder dysfunction and suggest a management protocol based on urodynamic findings.
共有58例骨髓发育不良患儿接受了影像学和膀胱测压评估，并定期随访，平均随访58个月。该组中30例（52%）表现为膀胱输尿管反流，其中16例为低度反流，14例为高度反流。6例患儿仅通过预防性抗菌药物治疗，低度膀胱输尿管反流即得到缓解，而6例需要减压治疗，2例需要抗反流手术，2例失访。尽管进行了充分的减压治疗，但14例高度膀胱输尿管反流患儿中仍有12例需要进行抗反流手术，2例失访。在接受手术的患儿中，没有反流复发，但有3例患儿出现上尿路恶化的迹象。我们描述了目前对神经源性膀胱功能障碍患儿膀胱输尿管反流的治疗方法，并根据尿动力学检查结果提出了一个管理方案。
