婴幼儿泌尿系结石29例

The clinical analysis of urolithiasis in 29 infants and toddlers

目的 了解婴幼儿泌尿系结石的临床特点,以便早期诊断,及时治疗。方法 总结29例婴幼儿泌尿系结石的临床资料,并进行临床分析。结果 本组男25例(86.21％),女4例。年龄最小4个月,婴儿17例,幼儿12例;上尿路结石16例(55.17％),男12例,女4例,临床主要表现无尿、排尿困难、血尿,占93.75％;下尿路结石13例(44.83％),均为男童,临床以排尿困难为主要表现,占84.61％;婴儿临床上以排尿困难和无尿为主要表现,占82.35％,而幼儿则以排尿困难为主要症状,占66.67％;结石可以血尿为首发症状(13.79％),反复出现;7例肾功能减退(24.14％),均为上尿路结石。结石检出率腹部B超90.5％,腹部平片72.2％,静脉肾盂造影44.4％。结论 小儿泌尿系结石可早期形成及发病,以男童多见,无尿、排尿困难和血尿是婴幼儿泌尿系结石的主要表现,上尿路结石易并肾功能减退,腹部B超是泌尿系结石最简便的检查方法之一。

Objective To know the clinical feature of urolithiasis in infants and toddlers and treat in time. Methods We collected the clinical data of 29 hospitalized infants and toddlers with urolithiasis. Results There were 25 boys and 4 girls. Their ages ranged from 4 months to 3 years, of them 17 cases in infants. We found that 16 patients had calculi in the upper urinary tract and 13 in the lower urinary tract. The most common symptoms were acute anuria (9 cases), dysuria (15 cases) and hematuria (4 cases) . Dysuria, however, was more common in the lower urinary tract (84.61 % ). The infants with upper urinary tract calculi presented as anuria and developed to acute renal insufficiency. B- ultrasound , IVP, and KUB had comfirmed the diagnosis of calculi in 90. 5 % , 44.4 % , 72.2 % respectively.Conclusions Urolithiasis can onset early in infants and toddlers and male was predominant. Clinical manifestations were variable and different from children and adult. Renal insufficiency can be developed easier in the upper urinary tract calculi. B- ultrasound was the simplest method for diagnosing urolithiasis.