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Abstract：
This study aims to investigate the factors effective in predicting the persistence of reflux after the first subureteric transurethral injection (STING) of dextranomer/hyaluronic acid copolymer in pediatric patients with vesicoureteral reflux. The data of patients without a previous history of surgery to treat vesicoureteral reflux and who underwent STING for the first time between September 2011 and November 2020 were investigated retrospectively. After considering exclusion criteria, of 199 patients, 127 patients and 180 renal units were suitable for inclusion. A renal unit-based evaluation was made. Age < 61 months (univariate: p = 0.001, multivariate: p = 0.015, HR: 2.352 (1.181-4.686), OR (95% CI)), moderate reflux level (grade 3) (univariate: p < 0.001, multivariate: p = 0.019, HR: 2.703 (1.177-6.209), OR (95% CI)), DRF (differential renal function) < 45 (univariate: p = 0.020, multivariate: p = 0.047, HR: 1.992 (1.009-3.935), OR (95% CI)), and UDR (ureteral diameter ratio) > 0.15 (univariate: p < 0.001, multivariate: p = 0.005, HR: 2.786 (1.368-5.672), OR (95% CI)) were found predictors of reflux persistence after STING surgery both univariate and multivariate analysis. High reflux level (grade 4-5) was statistically significant in univariate analysis (p < 0.001) but not statistically significant in multivariate analysis (p = 0.215). In our study, UDR and DRF were found to be factors affecting reflux persistence. UDR and DRF should be considered in order to predict reflux resolution in patients who will undergo STING.
摘要：
这项研究旨在探讨有效预测小儿膀胱输尿管反流患者首次经尿道下注射（STING）右旋二聚体/透明质酸共聚物后持续反流的因素。回顾性调查2011年9月至2020年11月期间无膀胱输尿管反流手术史并首次接受STING治疗的患者数据。在考虑排除标准后，199名患者，127例患者和180个肾脏单位适合纳入。进行基于肾单位的评估。年龄<61个月（单变量：p=0.001，多变量：p=0.015，HR：2.352（1.181-4.686），或（95%CI），中度反流水平（3级）（单变量：p<0.001，多变量：p=0.019，HR：2.703（1.177-6.209），或（95%CI），DRF（差异肾功能）<45（单变量：p=0.020，多变量：p=0.047，HR：1.992（1.009-3.935），或（95%CI），UDR（输尿管直径比）>0.15（单变量：p<0.001，多变量：p=0.005，HR：2.786（1.368-5.672），OR（95％CI）是STING手术后持续反流的预测因子，包括单因素和多因素分析。高反流水平（4-5级）在单变量分析中具有统计学意义（p<0.001），但在多变量分析中无统计学意义（p=0.215）。在我们的研究中,发现UDR和DRF是影响反流持久性的因素。应考虑UDR和DRF，以预测将接受STING的患者的反流消退。
