超常差异性功能在MAG3扫描中,在患有尿管盆结阻塞的儿童中 - 随访期间的流行率和皮叶造形术

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Sanni Värelä¹, Christoffer Jakobsson², Eva Persson³

¹Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden; Department of Surgery, Skåne University Hospital, Malmö, Sweden.

Journal of pediatric urology

|September 19, 2023

概括

在怀疑尿道结阻塞 (UPJO) 的儿童中,在MAG3扫描上发现超正常的功能差异 (snDRF) 在19%的病例中. 这一发现并没有增加化术的风险,这表明无论存在snDRF,都需要类似的管理.

科学领域:

儿科泌尿外科儿科泌尿外科
诊断成像诊断成像诊断成像
功能评估功能评估

背景情况:

怀疑尿道结阻塞 (UPJO) 的儿童可能在Technetium mercaptoacetyltriglycine光学扫描 (MAG3扫描) 上表现出悖论性的ipsilateral超正常差异性功能 (snDRF).
儿童UPJO中snDRF的临床意义和管理影响仍然不完全理解.

研究的目的:

确定怀疑UPJO的儿童中snDRF的流行率.
评估snDRF与需要热塑性手术的风险之间的关联.
探索国际儿科泌尿科医生在UPJO管理snDRF的观点.

主要方法:

在瑞典四家医院中,对怀疑单边UPJO的儿童进行MAG3扫描 (2005-2020年) 的回顾性队列研究.
定义为差异性功能 (DRF) 的SnDRF≥55%. 主要结局:基于DRF损失,绝对DRF或症状的铁皮造形风险.
国际问卷分发给儿科泌尿科医生关于snDRF管理;进行了后勤和Cox回归分析.

主要成果:

患有snDRF的患病率为19%,在男孩,产前水病例,年轻患者和左中更为常见.
在一个由264名儿童组成的队列中,随访时间中位数为6.6年,snDRF与皮叶造形手术风险增加无关 (aOR为0.98,aHR为1.00).
79名接受调查的儿科泌尿科医生中的大多数表示,他们不会根据snDRF的存在改变UPJO的管理.

结论:

在最初的MAG3扫描中,大约五分之一的儿童怀疑UPJO存在snDRF.
侧面的snDRF似乎不是需要在儿科UPJO中进行造术的独立风险因素.
对于UPJO的临床后续和管理策略应该保持一致,不管snDRF是否存在.

关键词:

液态化是一种化过程.皮耶洛普拉斯蒂术是指皮耶洛普拉斯蒂术.超正常的差异性功能

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