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Study of Vesicoureteral Reflux (VUR) in Children

儿童膀胱输尿管反流 (VUR) 的研究

基本信息

批准号：
12470325
负责人：
KOYANAGI Tomohiko
金额：
$ 9.54万
依托单位：
HOKKAIDO UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

项目摘要

1) Urodynamic study and renal scintigraphic evaluation were done on 14 boys with primary VUR. Their ages ranged 4 months to 10 years with an average 4.2 years. 8 were bilateral and 6 unilateral. Severity of VUR were grade III or less in 8 patients and grade IV or more in 6. Voiding pressure was apparently high of 82 cm H_2O in those (7 patients) older than 3 years old (group A) while it was 57 cm H_2O in 3 patients younger. Bladder instability was not found in group B while it was noted in 57 % of group A. There was no correlation among the renal scarring, voiding pressure and/or severity of VUR. High intravesical pressure, be it during voiding or with unstable contraction, appears to be relevant in the genesis and aggravation of VUR.2) Relevance of bulbar urethral (ring-like) stricture (i.e. Cobb's collar) to VUR was studied. In the past 5 years 74 boys (average age 5 years old) were noted to have the lesion. 54 per cent presented with febrile urinary infection and noted to have VUR. Urinary incontinence (diurnal and/or enuresis) and hematuria were also noted. Bulbar indentation was the roentgenographic feature, while all were confirmed endoscopically with infant cystourethroscope. Bladder instability was noted in 89 per cent. Transurethral incision (TUI) was effective in controlling presenting illnesses, VUR and instability over 93 per cent. In evaluating VUR in young boys the presence of congenital urethral stricture (Cobb's collar) is to be reminded.

1) 对 14 名患有原发性 VUR 的男孩进行了尿动力学研究和肾脏闪烁扫描评估。他们的年龄从4个月到10岁不等，平均4.2岁。 8 例为双侧，6 例为单侧。 VUR严重程度为Ⅲ级以下8例，IV级以上6例。3岁以上（A组）患者（7例）排尿压力明显较高，为82 cm H_2O，3岁以下患者为57 cm H_2O。 B 组未发现膀胱不稳定，而 A 组有 57% 出现膀胱不稳定。肾脏疤痕、排尿压力和/或 VUR 严重程度之间没有相关性。膀胱内高压，无论是排尿期间还是不稳定收缩时，似乎与 VUR 的发生和恶化有关。2) 研究了尿道球部（环状）狭窄（即 Cobb 环）与 VUR 的相关性。在过去 5 年里，有 74 名男孩（平均年龄 5 岁）被发现患有这种病变。 54% 的人出现发热性尿路感染，并注意到患有 VUR。还注意到尿失禁（昼间和/或遗尿）和血尿。球部压痕是X线检查的特征，而所有这些都通过婴儿膀胱尿道镜内镜证实。 89% 的人发现膀胱不稳定。经尿道切口 (TUI) 可有效控制 93% 以上的现有疾病、VUR 和不稳定性。在评估年轻男孩的 VUR 时，应注意先天性尿道狭窄（科布衣领）的存在。