对于患有膀脉逆流症的儿童的治疗管理
Valeria Chirico1, Filippo Tripodi1, Antonio Lacquaniti2
1Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
Journal of clinical medicine
|January 11, 2024
概括
持续抗生素预防 (CAP) 在患有膀外流 (VUR) 的儿童中有望预防脏痕,尽管手术可能会导致更多的复发性感染. 这两种治疗方法都为VUR管理提供了预后见解.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 在儿童中,膀肠道逆流 (VUR) 管理包括手术干预或持续抗生素预防 (CAP).
- 关于这些VUR疗法的长期有效性和并发症,存在相反的数据.
- 评估发烧性尿路感染 (UTI) 和VUR解决方案的复发对于治疗评估至关重要.
研究的目的:
- 为了比较手术治疗与CAP对儿科VUR的有效性.
- 分析发烧性尿路感染和VUR治疗后解决方案的复发率.
- 确定VUR儿童治疗成功或失败的预测因素.
主要方法:
- 研究了一组350名患有VUR的儿科患者.
- 用对比度增强的排泄性泌尿声学 (ceVUS) 证实了VUR的诊断;脏扫描评估了脏痕.
- 12个月后,分析了包括VUR复发,发烧性尿路感染和反流相关的病在内的结果.
主要成果:
- 手术导致27名儿童的发烧性尿路感染复发,特别是那些患有VUR等级III和V的儿童. 13名手术患者出现痕和慢性功能衰竭.
- 在140名患者中,CAP治疗导致30%的患者持续发烧性尿路感染. 95名重新评估的患者中有52人患有持续的VUR,所有人都有严重的等级.
- 与手术相比,CAP治疗显示出更好的预防脏痕,特别是在更高VUR等级的患者中. 晚期发病或新生儿VUR的可逆性有限.
结论:
- 持续的抗生素预防 (CAP) 可能比手术更有效地预防儿科VUR的脏痕,特别是在更高等级.
- 对VUR进行手术可能与更高的复发性尿路感染和脏痕率有关.
- 这项研究通过识别VUR治疗成功或失败的预测因素,提供预后信息,帮助临床决策.
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