Frey P, Lutz N, Jenny P, Herzog B
Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
J Urol. 1995 Aug;154(2 Pt 2):804-7. doi: 10.1097/00005392-199508000-00128.
Between June 1988 and September 1994, 100 girls and 32 boys 2 months to 15.5 years old (average 4.9 years) with 204 refluxing ureteral units were treated by endoscopic subureteral collagen injection. The collagen injected was of bovine origin and cross-linked with glutaraldehyde (Zyplast*). Followup ranged from 3 to 75 months (mean 33). Reflux was absent in 62.7% of cases 3 months after 1 endoscopic subureteral injection. Improvement to reflux grades I and II, generally not requiring further treatment, occurred in a further 15.2% of cases. A total of 66 ureters was injected twice. The overall cure rate after 1 or 2 injections was 79.4% 3 months after injection. There was no correlation between the risk of recurrent reflux and initial degree of reflux. Late recurrence of reflux following a reflux-free period occurred in 11.3% of the 204 units during the observation period, which varied from 3 months to 6 1/4 years. Reflux was absent after 1 or 2 injections, including late recurrence, in 70.6% of cases and in an additional 13.2% recurrent reflux was grade I or II, not necessitating any further treatment. Considering these results, subureteral collagen injection remains an adequate method of treatment for vesicoureteral reflux in children.
1988年6月至1994年9月，对100名女孩和32名年龄在2个月至15.5岁（平均4.9岁）的男孩的204个反流性输尿管单位进行了内镜下输尿管下胶原蛋白注射治疗。注射的胶原蛋白来源于牛，并与戊二醛交联（Zyplast*）。随访时间为3至75个月（平均33个月）。内镜下输尿管下注射1次后3个月，62.7%的病例反流消失。另外15.2%的病例改善至Ⅰ级和Ⅱ级反流，一般无需进一步治疗。共有66条输尿管接受了2次注射。注射1次或2次后3个月的总治愈率为79.4%。反流复发风险与初始反流程度之间无相关性。在观察期内，204个单位中有11.3%在无反流期后出现反流晚期复发，观察期从3个月至6.25年不等。1次或2次注射后，包括晚期复发，70.6%的病例无反流，另有13.2%的病例复发反流为Ⅰ级或Ⅱ级，无需进一步治疗。考虑到这些结果，输尿管下胶原蛋白注射仍然是治疗儿童膀胱输尿管反流的一种合适方法。
