三聚氰胺污染奶粉致小儿泌尿系结石53例随诊分析

Follow up of S3 cases of urinary calculi caused by melamine-contaminated infant milk powder

目的 分析三聚氰胺污染奶粉喂养小儿泌尿系结石的临床特征及预后.方法 回顾分析2008年8-11月我院住院的三聚氰胺污染奶粉致小儿泌尿系结石53例的临床表现、实验室化验、影像学检查、治疗效果、1年随访结果及预后.结果 53例患儿中男39例,女14例,男比女2.79：1：入院时主要临床表现排尿时哭闹、腹痛、血尿、少尿、无尿;实验室检查尿常规pH值均〈6（5.32±0.25）,血尿酸[（638.69 ±36.25）μmo/L]、尿素氮[（8.35±1.97）mmol/L]明显增高;彩色多普勒超声仪及CT显示双肾结石、单侧肾结石、双肾及单肾伴单侧输尿管结石、单侧输尿管结石、膀胱结石.内科治疗后,37例结石全部排出.pH值明显升高（6.52±0.47）,血尿酸[（382.31±29.57）μmo/L]、尿素氮[（5.15 ±1.92）mmol/L]明显下降.发病1年随诊结石排出者无复发.结论 三聚氰胺污染奶粉致小儿泌尿系结石内科治疗效果好：结石排出后复发少.

Objective To analyze the clinical features and prognosis of urinary calculi in children caused by melamine-contaminated milk. Methods Retrospective analysis of 53 cases of urinary calculi caused by melamine contaminated infant milk powder were performed. Clinical characteristics, lab measurements, colour Doppler ultrasound and CT examination results were collected, and the outcome of treatment and prognosis were followed up. Results In the 53 cases, there were 39 males and 14 females. The main clinical manifestations at admission included crying during urination, abdominal pain, hematuria, oliguria and anuria. Urine pH value was low with average of 5. 32 ±0. 25,blood uric acid was high with average of （638. 69 ±36. 25） μmol/L,blood urea nitrogen was high with average of （8. 35 ± 1. 97） mmol/L The colour Doppler ultrasound and CT examination showed calculi in both or one side kidney,or combined with calculi in both or one side ureter,calculi in one side ureter,or bladder calculi. After medical treatment,all calculi were exported,urine pH values increased to 6. 52 ±0. 47,blood uric acid blood and urea nitrogen decreased to （382. 31 ±29. 57） μmo/L and （5. 15 ±1.92） mmol/L No calculi reoccurred within one year of follow up. Conclusions Medical treatment of urinary calculi in children caused by melamine-contaminated milk powder was effective,and there were less stone recurrence after discharge.