肉毒素A在患有非神经性治疗耐药性功能障碍排泄的儿童中的作用 - 一项系统性审查
S A A Hoelscher1, I B de Angst1, Z A Buijnsters1
1Department of Pediatric Urology, Sophia Children's Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Journal of pediatric urology
|December 22, 2023
概括
毒素-A (BTX-A) 注射为患有功能障碍排泄 (DV) 的儿童提供安全有效的治疗方法,这些儿童对其他疗法没有反应. 这种治疗可以减少儿科患者的空虚后残留物,失禁和尿路感染.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 药理干预药理干预
- 尿动力学 尿动力学 尿动力学
背景情况:
- 功能障碍性排泄 (DV) 是一种常见的儿科排泄障碍,其特点是排尿期间不自发的外部尿道 (EUS) 收缩.
- 这种情况导致并发症,如高的空虚后残留物 (PVR),尿失禁和复发性尿路感染 (UTI).
- 对于一些儿科患者来说,VD的标准治疗可能是无效的,因此需要使用替代治疗策略.
研究的目的:
- 系统地审查间肉毒素-A (BTX-A) 注射用于治疗治疗不耐药的儿童功能障碍排泄的疗效和安全性.
- 评估BTX-A对患有DV的儿科患者关键泌尿动力学参数和临床结果的影响.
主要方法:
- 在主要数据库 (Embase,MEDLINE,Cochrane,Web of Science) 进行了系统的文献搜索.
- 包括的研究集中在用于儿科DV的间BTX-A的使用上,提取PVR,最大流速 (Qmax),重复注射和不良事件的数据.
- 由于数据异质性,采用了叙事合成方法,而不是元分析.
主要成果:
- 分析了五项涉及78名儿童 (68%女性) 的队列研究,年龄从8岁到10.5岁不等.
- 在所有研究中,BTX-A注射始终导致PVR显著减少.
- 治疗后观察到尿失禁的改善 (33-69%) 和尿路感染的减少,暂时的副作用包括增加的尿失禁,尿路感染和部麻木.
结论:
- 间BTX-A为患有耐火性DV的儿科患者提供了安全有效的选择,有效减少PVR,失禁和尿路感染.
- 结合BTX-A和泌尿疗法可以改善治疗结果.
- 进一步的研究是有必要的,以解决关于BTX-A治疗儿科功能障碍排泄的现有知识差距.
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