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Mechanism of vesicoureteric reflux prevention and evaluation of anti-reflux operation

膀胱输尿管反流的预防机制及抗反流手术的评价

基本信息

批准号：
61480338
负责人：
TSUCHIDA Seigi
金额：
$ 4.22万
依托单位：
AKITA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1986
资助国家：
日本
起止时间：
1986 至 1988
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-61480338/
关键词：
Vesicoureteric reflux VUR Mechanism of VUR Prevention 逆流防止手術腎組織尿管蠕動

项目摘要

Present study shows that vesicoureteric reflux was prevented by closing of intramucosal ureteral lumen. Ultrasound examination revealed that intramucosal ureteral lumen was closed except urine expulsion from ureteral orifice by peristalsis. Incomplete closing of intramucosal ureteral lumen was occurred by deficit of mucosal and/or muscle layers.VUR was classified into two groups-reversible VUR and irreversible VUR-according to responsibility to treatment. The reversible VUR was cured spontaneously or by conservative treatment. The irreversible VUR which did not respond to medical treatment was due to inflammatory sclerotic changes of mucosal and muscle layers.In sixteen cases results of the anti-reflux operation were evaluated. The degree and existence of VUR renal function, degree of urinary tract dilatation, proteinuria and urinary tract inefection were observed on each case before and after operation. Fourteen out of 16 cases were estimated to be successful, on the other hand 2 cases were estimated to be unsuccessful. The one unsuccessful case received hemodialysis due to progressive deteriorated renal function, and another case developed recurrence of VUR.In two cases urine flow around ureteral orifice was evaluated by color doppler technique before and after anti-reflux operation. Downward flow was detected, but upward flow was not detected. The evaluation of urine flow around ureteral orifice by color doppler technique might be useful method for the detection of VUR.

目前的研究表明，粘膜内输尿管管腔关闭可防止膀胱输尿管返流。超声检查显示，除输尿管口蠕动排出尿液外，其余输尿管粘膜内腔均关闭。输尿管黏膜层和/或肌层缺失导致输尿管管腔闭合不全。根据治疗责任将输尿管返流分为可逆性输尿管返流和不可逆返流。可逆性输尿管返流可自行治愈或保守治疗。治疗无效的不可逆性输尿管返流是由于黏膜和肌层的炎性硬化性改变所致。观察两组患者手术前后VUR、肾功能、尿路扩张程度、蛋白尿及尿路感染的程度及存在情况。16例中14例成功，2例不成功。1例因肾功能进行性恶化行血液透析失败，1例VU复发。2例患者在抗反流手术前后应用彩色多普勒技术检测输尿管口周围尿流量。检测到向下流动，但没有检测到向上流动。彩色多普勒技术评价输尿管开口周围的尿流变化可能是诊断输尿管返流的有效方法。