三聚氰胺致小儿泌尿系结石83例治疗回顾性分析

Retrospective analysis of the treatment of 83 children with urinary system calculi due to melamine

目的为了解三聚氰胺致小儿泌尿系结石的治疗转归。方法对2008-09-15～12-31三鹿奶粉中毒事件中本院筛查5 873名10岁以下小儿(重点是婴幼儿)发现泌尿系结石105例中83例住院患儿临床资料作回顾性分析。结果采用彩色B超、尿化验等方法筛查出单(双)肾、输尿管结石的83例住院患儿中, 结石伴肾或输尿管积水11例,镜下血尿7例,尿白细胞超过正常值6例,尿蛋白(+)～(+++)4例,腹部X光拍片8例,出现阳性结石影1例。大多数患儿症状轻微或无症状。83例住院患儿按卫生部推荐的治疗方案,均全部治愈,经一年多观察随访无一例复发或加重。结论儿童泌尿系统结石与积水原因很多,所涉的病例与食入含三聚氰胺污染的奶粉有直接关系,因此停止食用此类奶粉很关键。三聚氰胺中毒引起的结石较松散,B超为诊断此类结石的主要手段。大多数按卫生部推荐的诊疗方案治疗,效果良好。

Objective To understand the therapeutic prognosis of the children with urinary system calculi due to melamine. Methods The clinical data of 83 hospitalized children with urinary system calculi of 105 children with urinary system calculi whose urinary system calculi were found in the melamine poisoning screening in 5 873 children under 10 years of age （mainly infants and young children） performed in our hospital in Sanlu milk powder poisoning event from September 15 to December 31,2008 ,were retrospectively analyzed. Results In 83 hospitalized children with single （or double） renal or ureteral calculi confirmed by color ultrasound, urine test, ete, urinary system calculi complicated with hydrops were found in 11 children with urinary system calculi, microscopic hematuria were found in 7 children with urinary system calculi, increase of urine white blood cell count （ higher than the normal val- ue） were found in 6 children with urinary system calculi, urine protein qualitative test showed mild to moderate positive reaction in 4 children with urinary system calculi. Of 8 children with urinary system calculi who were examined by abdominal X-ray photography, positive calculi shadow was found in 1 child. The majority of children with urinary system calculi had mild symptoms or no symptoms. All 83 children with urinary system calculi were treated in accordance with the therapeutic scheme recommended by health ministry and cured. After the following up of more than one year, no case of relapse or exacerbation was found in 83 cured eases. Conclusion There are many reasons that cause urinary system calculi and hydrops in the children. In this study, the incidence of these diseases is correlated with the ingestion of melamine-contaminated milk powder. Therefore, it is important to stop the ingestion of this melamine-contaminated milk powder. The urinary system calculi due to melamine poisoning are looser, and B-type ultrasound is the main diagnostic tools for such calculi. The majority of children with urinary system calculi can be treated in accordance with the therapeutic scheme recommended by health ministry, and the therapeutic effects are good.