嬰幼兒三聚氰胺相關(guān)泌尿系結(jié)石致急性腎衰竭診療分析-文庫吧資料
2024-08-17 15:25本頁面
【正文】 11月2日發(fā)表于《中華兒科雜志》46卷810－815頁，文章仍在修改中，以最終印刷版本為準?？焖偻ǖ缷胗變喝矍璋废嚓P(guān)泌尿系結(jié)石致急性腎衰竭診療分析孫寧 沈穎 孫嬙 李旭冉 賈立群 張桂菊 張濰平 陳植 樊劍鋒 蔣也平 馮東川 張銳鋒 朱孝宇 肖宏展作者單位：100045 首都醫(yī)科大學附屬北京兒童醫(yī)院 泌尿外科（孫寧、李旭冉、張濰平），腎臟內(nèi)科（沈穎、孫嬙、張桂菊、陳植、樊劍鋒、蔣也平），影像科（賈立群）；徐州市兒童醫(yī)院外科（馮東川、朱孝宇），內(nèi)科（張銳鋒）；北京微量化學研究所（肖宏展）。方法 回顧首都醫(yī)科大學附屬北京兒童醫(yī)院和徐州市兒童醫(yī)院2008年收治的34例因食用三聚氰胺污染的嬰幼兒配方奶粉致泌尿系結(jié)石、梗阻發(fā)生急性腎衰竭的患兒。結(jié)果 34名患兒均存在急性腎衰竭，血尿素氮（）mmol/L，血肌酐（）μmol/L。膀胱鏡治療組血肌酐降至正常的平均時間為() d；切開取石組() d；透析組() d；內(nèi)科保守治療組() d。經(jīng)治療34例患兒急性腎衰竭全部治愈，泌尿系結(jié)石完全或部分排出。 結(jié)論 三聚氰胺污染嬰幼兒配方奶粉可以導致嬰幼兒泌尿系結(jié)石引發(fā)的梗阻性急性腎衰竭，治療首選藥物或透析方法糾正電解質(zhì)紊亂,特別是高鉀血癥，盡快通過內(nèi)、外科方法解除梗阻引流尿液。[關(guān)鍵詞]結(jié)石； 泌尿系疾?。?腎功能衰竭，急性； 三聚氰胺； 嬰幼兒Melamine related urinary calculus and acute renal failure in infantsSUN Ning*，SHEN Ying，SUN Qiang，LI xuran，ZHANG guiju，ZHANG weiping，CHEN zhi，F(xiàn)AN jianfeng，JIANG Yeping, FENG Dongchuan，ZHANG Ruifeng, ZHU Xiaoyu, XIAO Hongzhan. *Division of Urology, Department of Pediatric Surgery, Beijing Children’s Hospital Affiliated to Capital Medical University，Beijing 100045，ChinaCorresponding author：SHEN Ying （Email：ying_116sh）【Abstract】 Objective To summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk. Methods Data of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children’s Hospital affiliated to the Capital Medical University and the Xuzhou Children’s Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, image features as well as effects of 4 types of therapies. Results All the 34 infants with urinary calculus were plicated with acute renal failure, their blood urea nitrogen (BUN) was （）mmol/L and creatinine (Cr) was （）μmol/L. The chemical analysis on the urinary calculus sampled from 14 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was （） d for cystoscopy group, （）d for lithotomy group, （）d for dialysis group, and （）d for medical treatment group, which had no statistically significant difference（P=）. Renal failure of all the 34 infants was rerelieved within 1 to 7 days
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