婴儿食用三聚氰胺污染奶粉致急性肾后性肾功能衰竭的治疗

Treatment of infants suffering from acute post renal failure after consumption of melamine contaminated powdered milk

目的探讨因食用三聚氰胺污染奶粉致急性肾后性肾功能衰竭婴儿的外科急诊处理方法与疗效。方法应用半硬性输尿管镜（F6．8）逆行输尿管插管冲洗术11例，开放输尿管切开取石术2例。结果本组除1例开放输尿管切开取石术后5h患儿又出现无尿且血红蛋白持续下降，再次行切口探查和腹膜透析外，其余12例均顺利恢复。本组13例肾功能均恢复正常，无手术并发症。结论对婴儿因食用i聚氰胺污染奶粉致上尿路结石引起的急性肾后性肾功能衰竭，在输尿管镜下逆行插管置入输尿管导管冲洗术是一种微创、安全而又有效的治疗方法；对婴儿尿道狭小输尿管镜不能进入者，开放输尿管切开取石术也是一种有效的方法，但对有明显出血倾向者需先纠正出血倾向后再考虑开放手术解除梗阻。

Objective To evaluate the surgical emergent treatments and curative effects on infants suffering from acute post renal failure by consumption of powdered milk contaminated by melamine. Methods Eleven cases were treated with retrograded catheterizations of ureter with semi-rigid ureteroscopy （F 6. 8） and 2 cases were treated with. The renal function was followed up in these patients. Results Only 1 patient got anuria and whose haemoglobin continued to drop postoperatively. This patient underwent a redo operation and peritoneal dialysis. The other 12 patients recovered well. The renal function of all the 13 children got back to normal without surgical complications. Conclusions The technique of retrograded catheterization of ureters under ureteroscope was a minimally invasive, safe and effective therapy for infants with post renal acute renal failure by consumption of powdered milk contaminated by melamine. For those infants whose urethras are thin and small, is also an effec tive method. But the bleeding tendency should be corrected before open.