三聚氰胺与婴幼儿尿路结石

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目的 探讨三聚氰胺污染奶粉喂养史婴幼儿泌尿系结石临床特点.方法 回顾性分析165例三聚氰胺污染奶粉喂养史泌尿系结石住院婴幼儿的临床资料.患儿按照卫生部推荐的进行治疗.另选30例无三聚氰胺污染奶粉喂养史住院病例作为对照组.结果 患儿发病年龄2岁以内占83.6%(138/165),其中6~12个月患儿占41.2%(68/165).患儿中49.7%(82/165)有临床症状,主要表现为排尿困难16.9%(28/165)、不明原因哭闹14.6%(24/165)、少尿无尿10.9%(18/165)及血尿7.3%(12/165).共发现233处结石,肾结石患儿比例高达79.5%(131/165),尿道结石仅1.2%(2/165).结石直径为2~16 mm,其中4~10mm占63.5%(148/233),>10mm者9.9%(23/233).除1例双肾结石尿路梗阻行逆行输尿管插管手术治疗外,其他患儿均采用保守治疗.治疗(9±5)d后患儿症状均消失,结石排出率为43.0%.结论 三聚氰胺污染奶粉喂养能引起婴幼儿泌尿系结石,多在喂养6~12个月后发病.非手术治疗效果好.“,”Objective To investigate the clinical features of the urolithiasis in infants who were fed with melamine contaminated powdered milk. Methods The clinical data of 165 infants aging from 50 days to 3 years(14 ± 9m) with urinary calculus who had the history of consuming melamine con- taminated powdered milk were retrospectively analyzed. All cases were treated according to the treat- ment guideline of Chinese Ministry of Health. Blood biochemical indicators (BUN, Scr, SUA) and u- rine pH value were analyzed. Thirty patients without urinary diseases or the history of consuming mel- amine contaminated powdered milk were chose as the control group. Results Eighty point six percent of the cases (138/165) had the onset under the age of 2 years, of whom 41.2% (68/165) aged from 6 to 12 months. The ratio of male to female in the 165 cases Was 2.6:1. Half of cases (49.7%) presented different clinical symptoms: dysuria(16.9%), infantile colic(14.6%), oliguria or anuria(10.9%) and hematuria(7.3%). The diameter of calculi ranged from 2mm to 16mm, of which 63.5% were between 4mm to 10mm and 9.9% were beyond 10mm After hospitalization treatment for 9 ± 5 d, clinical symptoms of all cases had vanished, and 43% cases discharged stones. Conclusions The mela- mine calculus occurred most likely in infants when fed with melamine contaminated powdered milk for over 6 months to 12 months. Nonsurgical management could get satisfactory curative effect.
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