摘要
目的探讨食用受三聚氰胺污染的婴幼儿配方奶粉致泌尿系结石患儿的临床特点、诊断和治疗方法。方法分析兰州军区兰州总医院泌尿外科2008年收治的35例因食用三聚氰胺污染的婴幼儿配方奶粉致泌尿系结石的患儿其流行病学、临床表现及影像学特点,总结两种不同的治疗方法及疗效。结果10名患儿均存在急性肾衰竭,血尿素氮(26.1±7.5)mmol/L,血肌酐(370.5±198.5)μmol/L。对留取的10例结石标本分析证实,结石是三聚氰胺和尿酸的合成体。输尿管镜下内支架置入术后,治疗组血肌酐降至正常的平均时间为(4.0±2.0)d;25名患儿内科保守治疗。经治疗10例患儿急性肾衰竭全部治愈,泌尿系结石完全或部分排出;25名患儿内科保守治疗;泌尿系结石完全或部分排出。结论三聚氰胺污染婴幼儿配方奶粉可以导致婴幼儿泌尿系结石,治疗方法可对急性肾功能衰竭患儿尽快通过内、外科方法解除梗阻引流尿液。患儿预后尚可。
Objective To summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus developed after being fed with melamine tainted formula milk. Methods Data of infant patients with urinary calculus due to melamine tainted formula milk admitted to the Lanzhou general hospital of Lanzhou military region in 2008 were used to analyze the epidemi01ogical characteristics, clinical manifestations, diseases mechanism as well as effects of 2 types of therapies. Results 10 infants with uri- nary calculus were complicated with acute renal failure, their blood urea nitrogen （BUN） was （26.1±7.5） mmol/L and creatinine （Cr） was （3705±198.5）μmol/L. The chemical analysis on the urinary calculus sampled from 10 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for therapies for returning Cr to normal was （3.5±1.9） days for ureteraloscopy group. Renal failure of all the 10 infants was relieved within 1 to 8 days, averaging （4.0-＋2.2） days. 25 of the infants treated with expectant treatment all recovered. Conclusion Melamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated to relieve the obstruction with available medical and surgical methods as soon as possible. It is observed that the short term prognosis is satisfactory.
出处
《中华腔镜泌尿外科杂志（电子版）》
2009年第4期10-13,共4页
Chinese Journal of Endourology(Electronic Edition)
