Puri P, Palanimuthu M, Dass L
National Children's Hospital, Dublin, Ireland.
Eur Urol. 1995;27(1):67-70. doi: 10.1159/000475127.
Fifty-two infants (75 ureters) with primary high-grade vesicoureteric reflux (VUR) treated endoscopically by subureteric injection of Polytef paste (STING) were followed up for 1-9 years. There were 30 boys and 22 girls and their ages ranged from 2 to 12 months. Forty-five percent of ureters had grade III VUR, 40% had grade IV and 15% had grade V VUR. Reflux ceased in 49 (65%) ureters after a single injection. Twenty-four percent of ureters in this series required more than one injection of Polytef paste to correct VUR. STING failed to correct VUR in 3 (4%) ureters. Eighty percent of the 49 ureters corrected after a single injection of Polytef required < 0.2 ml of paste per ureter to correct reflux. Ninety-three percent of ureters continue to show absence of VUR 1-9 years after endoscopic correction. Three of the 5 recurrences were only of grade I or grade II severity and required no treatment. No untoward effects were seen in these children with the use of Teflon as an injectable biomaterial. This day care procedure is simple, safe and effective in correcting high grades of reflux in infants.
对52例原发性重度膀胱输尿管反流(VUR)患儿(75条输尿管)进行输尿管下注射聚四氟乙烯糊剂(STING)内镜治疗,并随访1至9年。其中男孩30例,女孩22例,年龄2至12个月。45%的输尿管为Ⅲ级VUR,40%为Ⅳ级,15%为Ⅴ级VUR。单次注射后,49条(65%)输尿管反流消失。本系列中24%的输尿管需要多次注射聚四氟乙烯糊剂才能纠正VUR。3条(4%)输尿管STING治疗失败。单次注射聚四氟乙烯后反流得以纠正的49条输尿管中,80%每条输尿管所需糊剂<0.2 ml。内镜纠正后1至9年,93%的输尿管仍无VUR。5例复发中3例仅为Ⅰ级或Ⅱ级严重程度,无需治疗。使用聚四氟乙烯作为可注射生物材料,这些患儿未出现不良反应。这种日间护理程序在纠正婴儿重度反流方面简单、安全且有效。