婴幼儿三聚氰胺致泌尿系结石诊疗分析

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.     

问题奶粉事件中婴幼儿泌尿系统结石成分鉴定

目的 通过对婴幼儿泌尿系统结石的成分分析,探讨结石成因,以利于预防和治疗.方法 收集婴幼儿泌尿系统结石标本16例,均有同一品牌问题奶粉喂养史.结石组分用高效液相色谱分离制备,电喷雾质谱、电子轰击质谱和傅里叶变换红外光谱进行结构鉴定,并用高效液相色谱对结石中的主要组分进行定量测定.结果 通过分离和组分结构鉴定及定量测定.结石中的主要组分为三聚氰胺和尿酸,尿酸和三聚氰胺的比例约为2:1(摩尔比).结石中尿酸平均含量为(53.9±11.7)%,三聚氰胺为(23.2±5.7)%.结论 因食用问题奶粉而导致婴幼儿泌尿系统结石的主要原因是三聚氰胺与尿酸形成了不溶性盐而导致结石形成.     

三聚氰胺致婴幼儿急性肾功能衰竭临床特征及治疗(附2例报告并文献复习)

目的 探讨三聚氰胺致婴幼儿泌尿系结石急性肾衰的临床特点及其治疗.方法 报告本院收治128例问题奶粉泌尿系结石患儿中2例三聚氰胺致泌尿系结石急性肾功能衰竭患儿的临床资料并复习有关文献.本例以无尿、食欲减退、恶心、呕吐等症状就诊,其中1例行Cr引导微通道经皮肾造瘘(MPCN)治疗.1例经利尿、水化、碱化尿液治疗.结果 1例行CT引导微通道经皮肾造瘘治疗后恢复,无腹腔脏器的损伤,无血管的损伤.1例经利尿、水化、碱化尿液治疗后肾功能恢复.结论 CT能对拟行 mini-PCN术的病例作出准确判断,特别是婴幼儿,术中CT引导可提高穿刺成功率,并有效的避免血管及脏器的损伤,微创出血少,术后可正确评估手术疗效,CT引导mini-PCN术治疗婴幼儿急性肾功能衰竭(梗阻型)安全可行.     

三聚氰胺致婴幼儿急性肾功能衰竭临床特征及治疗(附2例报告并文献复习)

目的 探讨三聚氰胺致婴幼儿泌尿系结石急性肾衰的临床特点及其治疗.方法 报告本院收治128例问题奶粉泌尿系结石患儿中2例三聚氰胺致泌尿系结石急性肾功能衰竭患儿的临床资料并复习有关文献.本例以无尿、食欲减退、恶心、呕吐等症状就诊,其中1例行Cr引导微通道经皮肾造瘘(MPCN)治疗.1例经利尿、水化、碱化尿液治疗.结果 1例行CT引导微通道经皮肾造瘘治疗后恢复,无腹腔脏器的损伤,无血管的损伤.1例经利尿、水化、碱化尿液治疗后肾功能恢复.结论 CT能对拟行 mini-PCN术的病例作出准确判断,特别是婴幼儿,术中CT引导可提高穿刺成功率,并有效的避免血管及脏器的损伤,微创出血少,术后可正确评估手术疗效,CT引导mini-PCN术治疗婴幼儿急性肾功能衰竭(梗阻型)安全可行.     

80例三聚氰胺致婴幼儿泌尿系结石治疗的临床分析

目的回顾性分析80例三聚氰胺致婴幼儿泌尿系结石患儿的临床资料,提高对婴幼儿泌尿系结石的治疗水平。方珐纳入2008年9月-2008年11月在兰州大学第二医院诊治的80例三聚氰胺致婴幼儿泌尿系结石患儿,采用内科保守治疗或外科干预（输尿管镜下碎石及输尿管支架管置人术、微创经皮肾镜碎石术MPcNL）。培杲37例患儿采用内科保守治疗两周后30例结石完全排除,7例结石减小;43例采用外科干预,术后24h内患儿均出现多尿,尿量约为800-2500mL。复查B超,41例结石完全排出,2例结石减小。结论内科保守治疗和外科干预治疗对三聚氰胺致婴幼儿泌尿系结石患儿具有明显疗效,其中微创外科治疗可作为三聚氰胺致婴幼儿泌尿系结石梗阻患儿的首选方法。     

MDROs尿路感染的危险影响因素及血清PCT、尿β2-MG的早期诊断价值

目的探讨输尿管上段结石并发多重耐药菌(MDROs)尿路感染的危险影响因素, 并分析血清降钙素原(PCT)、尿β2-微球蛋白(β2-MG)的早期诊断价值。方法选取2018年2月至2020年10月本院收治的259例输尿管上段结石患者, 根据是否并发MDROs尿路感染分为MDROs组(31例)和无MDROs组(228例)。比较两组的年龄、性别、体重指数、饮酒史、吸烟史、高脂血症、糖尿病、心脏病、高血压、结石大小、结石数量、鹿角形结石、泌尿系梗阻、手术方式、导尿管留置时间、术后结石残留、生化检验指标[白细胞计数(WBC)、中性粒细胞百分比(NEU)、尿素氮(BUN)、肌酐(Cr)、PCT、C反应蛋白(CRP)、尿β2-MG];采用Pearson分析WBC、NEU、PCT、CRP与BUN、Cr、尿β2-MG的相关性;采用多因素logistic回归分析MDROs尿路感染的相关影响因素, 采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析各生化检验指标的诊断价值。结果两组糖尿病、泌尿系梗阻、手术方式、导尿管留置时间、术后结石残留、WBC、NEU、BUN、Cr、PCT、CRP、尿β2-MG比较...     

尿α1和β2-微球蛋白含量变化在草酸钙结石形成中的作用

目的 探讨α1微球蛋白(α1-MG)、β2微球蛋白(β2-MG)含量变化在草酸钙结石形成中的作用. 方法 2010年7月至2010年9月收治结石患者66例.男45例,女21例.年龄13 ～78岁,平均(51.2±15.2)岁.单侧肾结石30例,双肾结石14例,单侧输尿管结石17例,膀胱结石5例.按照红外光谱仪对结石成分的分析结果分为草酸钙组和非草酸钙组.对照组34例,男22例,女12例.年龄12～80岁,平均(47.2±14.7)岁.对3组患者血液生化及24 h尿液生化,α1 -MG及β2-MG含量进行统计学比较分析. 结果 3组年龄、性别比差异无统计学意义.草酸钙组SCr值为(81.9±19.2)μmol/L,BUN为(6.3±2.9) mmol/L,非草酸钙组分别为(82.2±19.4) μmol/L,(6.4±2.3) mmol/L,与对照组(62.3±15.5) μmol/L、(5.0±1.4)mmol/L比较,差异有统计学意义(P＜0.05).草酸钙组尿α1 -MG为(7.6±8.3) mg/L,β2-MG为(514.5±630.5) mg/L,高于非草酸钙组的(3.0±1.7) mg/L和(170.0±117.2)mg/L及对照组的(3.6±2.6) mg/L,(179.7±159.3)mg/L,差异有统计学意义(P＜0.05).非草酸钙组尿尿酸含量(3604.8±1291.5) μmol/24 h,与草酸钙组( 2643.3±693.6) μmol/24 h及对照组(2678.3±948.2) μmol/24 h比较差异有统计学意义(P＜0.05). 结论 血α1 -MG、β2-MG含量变化可能在草酸钙结石的形成中有重要的影响作用.     

问题奶粉致尿路结石形成机制初探及诊治建议

目的：问题奶粉中所含的三聚氰胺是引发婴幼儿泌尿系结石形成的主要有毒物质，但其导致结石形成的机制至今未明。目前已知，这种结石的成分主要是二水尿酸和尿酸铵，所以本文通过这两种成分的代谢过程来逆向推导这种特殊结石形成的过程，同时也提出一些相关的诊断和治疗上的建议。     

5F输尿管导管在婴幼儿尿道结石治疗中的应用

目的探讨5 F输尿管导管在婴幼儿尿道结石治疗中的安全性及临床效果。方法对7例用含三聚氰胺婴幼儿配方奶粉喂养的尿道结石婴幼儿采用5 F输尿管导管留置导尿3 d,注入10 mL灭菌石蜡油后拔出,随访、复查泌尿系彩超、尿常规1月。结果 7例输尿管导管均顺利进入膀胱,拔出导管后结石顺利排出,无肉眼血尿、感染及排尿时哭闹。结论 5 F输尿管导管导尿治疗婴幼儿尿道结石是一种安全、有效的治疗措施。     

三聚氰胺污染奶粉致双肾结石婴幼儿2年后随访分析

目的：探讨三聚氰胺污染奶粉致双肾结石对婴幼儿生长发育的影响。方法：对2008年7～10月治疗的50例三聚氰胺双肾结石患儿（双肾结石组）进行2年后随访。随访包括泌尿系超声检查、肾功能检查、尿常规,同时记录身高、体重、临床症状及并发症情况。选取50例无三聚氰胺污染奶粉喂养史的正常儿童作为对照组,比较两组间的相关参数差异。结果：41例患儿得到成功随访。28例带石出院患儿中21例结石消失,5例变小,1例无明显变化,另1例变大。15例出院时仍有双侧或单侧肾积水患儿中9例消失,5例减轻及1例无明显变化。双肾结石组患儿补钙的比例明显低于对照组（P〈O．05）,身高偏低的比例明显高于对照组（P〈O．05）,体重差异无统计学意义（P〉O．05）。随访时未发现泌尿系占位性病变。结论：三聚氰胺污染奶粉致双肾结石患儿2年后随访显示,泌尿系统发育及生长发育未见明显影响。     

Acute kidney injury caused by consumption of melamine-contaminated infant formula in 47 children: a multi-institutional experience in diagnosis, treatment and follow-up

Since the spring of 2008, an epidemic of urinary tract stones was noted among children in China. This is believed to be associated with consumption melamine-contaminated powdered formula. A few patients presented with acute kidney injury (AKI) due to bilateral renal or ureteral calculi requiring surgical intervention to relieve the obstruction. We retrospectively analyzed clinical and laboratory data, ultrasonograms and treatment methods in children with melamine-induced urolithiasis and AKI who were hospitalized at seven hospitals from September to November 2008 in Gansu Province, China. Treatment given included conservative treatment, cystoscopic or urethroscopic lithotripsy, retrograde ureteral catheterization, ureterolithotomy and nephrostomy. Patients were monitored postoperatively with data of ultrasonography, urinalysis and blood and urine biochemistry. The mean age of the 47 children was 10 months (mean ± SD, 10.83 ± 5.11 months). Thirty-four (72.34%) were male. Calculi size ranged from 3 to 14 mm in diameter. Nine patients (19.15%) were successfully treated with conservative treatment; 32 (68.09%) underwent retrograde ureteral catheterization and eight had simultaneous cystoscopic or urethroscopic stone removal; four were successfully treated with ureterolithotomy, and 1 underwent percutaneous nephrostomy. Thirty-eight patients were followed up for a mean ± SD of 18.50 ± 5.27 months and their renal functions were found to have completely recovered. Five (13.16%) cases had residual renal stones with diameter ranging from 2 to 4 mm. Therefore, this study has demonstrated that melamine-induced urolithiasis could lead to AKI. Removing obstruction promptly by surgical intervention has been found to be effective with satisfactory outcomes observed at mean follow-up period of 18-month. However, residual renal stone remained in 13.16% of the cases which required continued close observation.     

Extracorporeal shock wave lithotripsy for cystine urolithiasis in children: Outcome and complications

The Siemens Lithostar Litotriptor was used to treat 6 children withcystine nephrolithiasis, previously treated by open surgery. Fivechildren had renal calculi (3 multiple caliceal, 2 pelvis) and one hadureteral calculus. Stone size ranged from 0.2–2.5 cm in diameter,and stone burden was from 0.24 to 10.81 cm³ per kidney. Fromone to 4 ESWL sessions per unit were applied, with a total of 1,800 to12,000 shock waves. The stone free rate at 3 months was 50%. Acomplete elimination was obtained with cystine stones in renal pelvisand ureter, however, up to 4 ESWL treatments failed in caliceal stones.Rather location of cystine calculi than previous surgery was associatedwith ESWL success rate. Two patients with positive urine cultures weresuccessfully treated with appropriate antibiotics before ESWL wasattempted. Perirenal hematoma was major complication demonstrated byradionuclide scintigraphy in one patient, and resolved spontaneously by3 months. In the combined treatment of cystine urolithiasis in childrenESWL, as auxillary procedure, was safe and effective in pelvis stone butfailed in caliceal stones. Medical dissolution for retained fragmentswas found effective.     

Metabolic features and renal outcomes of urolithiasis in children

Aim: The incidence of pediatric urolithiasis has increased over the last century because of dietary changes, metabolic abnormalities, climate change, and genitourinary abnormalities. Data on pediatric urolithiasis in non-endemic countries are limited. The aim of this study was to evaluate the clinical findings and metabolic etiology of urolithiasis in Korean children. Material and methods: The medical records of 73 Korean children who were newly diagnosed with urolithiasis from January 2010 to December 2013 were retrospectively analyzed. Evaluation of metabolic risk factors, including hypercalciuria, hyperuricosuria, hypomagnesuria, hyperoxaluria, and hypocitraturia, required analysis of 24-h urine specimens or, alternatively, for infants and toddlers, the solute-creatinine ratio in spot urine. Results: The male-to-female ratio of the included patients was 1.3:1. The median age at diagnosis was 10.1 years, and the patients were divided into two age groups with pre-school-age children (n?=?27, 37.0%) and school-age children (n?=?46, 63.0%). While flank pain was more common in school-age children, incidentally detected or urinary tract infection (UTI)-associated urolithiasis was more common in pre-school-age children. Eight patients (11.0%) had renal function deterioration associated with urolithiasis, and three patients (4.1%) progressed to chronic kidney disease. Metabolic abnormalities according to urine chemistry were found in 30 patients (41.1%), including hypercalciuria in 21.9%, hyperuricosuria in 11.0%, hypomagnesuria in 4.1%, hyperoxaluria in 1.4%, hypocitraturia in 1.4%, and cystinuria in 1.4%. Conclusion: We suggest that school-age children with renal colic and pre-school-age children with UTI should be evaluated for urolithiasis. Additionally, the evaluation for metabolic risk factors is important in order to prevent recurrence and renal insufficiency.     

Xanthine stone in the urinary bladder of a male child

Urinary tract calculi composed primarily of xanthine are rate both in adults and children. We describe the clinical presentation and management of a 3.5-year-old boy with hereditary xanthinuria (an autosomal recessive disorder of purine metabolism) and primary bladder calculus formed from xanthine. To our knowledge this case demonstrates a previously undescribed form of xanthinuria in childhood. Xanthine stones, although rare, should be considered in the diagnosis of urolithiasis.     

Ultrasonographic findings of adhesion ileus--with special reference to surgical indications

Eighty-one cases with adhesion ileus were examined by ultrasonography from January 1983 to July 1987. In this study, the association of ultrasonographic findings with surgical indications for adhesion ileus was evaluated. The subjects were divided into three groups: Group I, consisting of 29 cases of simple ileus improved by conservative treatment; Group II, 24 cases of simple ileus which required surgical treatment and Group III, 28 cases of strangulation ileus. In comparison with Group I, Group mean value of II + III which required surgical treatment showed a significantly larger maximum diameter of the dilated intestine (3.2 +/- 0.7 cm for Group I vs 3.8 +/- 0.5 cm for Group mean value of II + III) and significantly higher incidences of wall thickening and ascites (respectively 21% and 31% from Group I vs 54% and 73% from Group mean value of II + III). In comparison with the cases of simple ileus (Group mean value of I + II), those of strangulation ileus (Group III) showed significantly higher incidences of akinetic dilated intestine and ascites (respectively 17% and 43% from Group mean value of I + II vs 93% and 86% from Group III). These results make us conclude that ultrasonography is highly useful in deciding surgical indications for adhesion ileus.     

三聚氰胺所致婴幼儿尿路结石的综合治疗分析

目的 总结含三聚氰胺配方奶粉所致婴幼儿尿路结石的治疗手段及疗效.方法 有三鹿奶粉喂养史尿路结石患儿228例.男165例,女63例,年龄4个月～3岁.平均11个月.双肾结石144例.单侧肾结石54例.结石直径0.5～2.5 cm;双侧输尿管结石合并中重度肾积水8例.一侧输尿管结石合并中重度肾积水7例,结石直径0.4～lI 1 cm;膀胱结石合并尿潴留5例,尿道结石合并尿潴留10例,结石直径O.5～1.3 cm.患儿均经B超、CT检查确诊.分4组:①肾功能衰竭组15例(6.6%),少尿5～10 d 2例、无尿1～5 d 13例,实验室检查BUN平均32一mmol/I,SCr平均750μmol/L.13例采用经尿道输尿管镜下碎石、碱性药物溶石、双J管置入术,术后碱性药物溶石治疗;2例在B超引导下行经皮肾穿刺造瘘引流术、肾盂内间歇性碱性药物灌洗溶石.②输尿管结石合并中重度肾积水15例,行输尿管镜下碎石清石、双J管置入术及碱性药物溶石治疗.③膀胱、尿道结石合并急性尿潴留15例,采用经尿道输尿管镜下第三代碎石清石系统碎石清石.④单纯肾结石183例,采用碱性药物治疗1～8周.其中113例口服碳酸氢钠片0.15 g,2次/d;23例口服柠檬酸氢钾钠2.4 g/d;47例口服10%柠檬酸钾溶液,5 m1,3次/d.61例经碱性药物治疗＞8周疗效差者行ESWL及碳酸氢钠注射液溶石治疗,尿pH＞7.5时停药.对有肾功能损害患儿每天复查肾功、电解质直至正常.228例患儿随访1～3个月.统计数据采用SPSS 13.0软件分析.结果 组①患儿术后12～24 h内即出现多尿,多尿期持续24～72 h.尿量800～2500 ml/24 h,术后48～96 h尿量逐渐恢复正常,术后1～5 d BuN及SCr均恢复正常,1～2周4例肾、输尿管结石基本排净,2～4周15例结石全部排净.组②患儿治疗后1～2周结石完全排净.组③患儿经微创手术均一次性清除结石,立即恢复正常排尿,3 d后复查B超,膀胱、尿道内均无残余结石.组④经碳酸氢钠治疗组结石2周排净4例,4周排净18例,13周排净15例,8周后结石明显变小变淡34例,结石无明显变化42例;口服柠檬酸氧钾钠治疗组结石1周排净4例,2周排净7例,4周排净10例,6周排净2例;口服10%柠檬酸钾溶液组结石1周排净3例.2周排净5例,4周排净16例,8周排净11例,8周后结石明显变小变淡8例,结石无变化4例.柠檬酸盐治疗组与碳酸氢钠治疗组疗效比较差异有统计学意义(P-O.001),柠檬酸盐组内比较差异无统计学意义(P=0.372).61例患儿行ESWL及继续碱性药物溶石治疗患儿1～6周结石排净49例,结石缩小8例,无明显变化4例.结论 三聚氰胺所致婴幼儿尿路结石早期以内科观察治疗为主,发生急性肾功能衰竭、输尿管中重度积水及下尿路急性梗阻时应以外科干预为主,解除梗阻、保护肾功能、恢复正常排尿.治疗后期,结石特点发生变化,单纯碱性药物治疗无效者应采用ESWL治疗.     

A new approach to the diagnosis of children’s urolithiasis based on the Bonn Risk Index

Published data on the association between calcium oxalate (CaOx) crystallization and kidney stone disease in children are scarce. The aims of this study were to determine CaOx crystallization using the Bonn Risk Index (BRI) in children with urolithiasis in comparison to healthy controls, to evaluate the relationships between BRI and urinary parameters, such as pH, calciuria, oxaluria and citraturia, and to assess the association between BRI and the size of renal stones. We compared the BRI in 142 Caucasian children and adolescents (76 girls, 66 boys) aged 3-18 years with kidney stones and 210 healthy age- and sex-matched controls without urolithiasis. Urinary ionized calcium ([Ca2+]) was measured using a selective electrode, while the onset of spontaneous crystallization was determined using a photometer and titration with 40 mmol/L ammonium oxalate (Ox2-). The calculation of the BRI value was based on the Ca2+:Ox2- ratio. High-resolution renal ultrasonography was carried out to estimate the size of the renal stones. The BRI values were 15-fold higher in children with renal stones than in healthy children without stones. The same trend was shown by BRI/kg body weight (tenfold greater in children with renal stones than in healthy children without stones), BRI/per 1.73 m2 body surface (13-fold greater) and BRI/body mass index (23-fold greater). No association was observed between BRI and the diameter of stones. Children with kidney stones, both males and females, had an increased BRI compared with subjects without urolithiasis. High BRI suggests an association with lower urinary pH, hypercalciuria, hyperoxaluria or hypocitraturia, which are all risk factors of kidney stones. An increased BRI in children, although unrelated to renal stone size, reflects the risk of calcium oxalate crystallization and may indicate early metabolic disorders leading to urolithiasis.     

Updated epidemiologic study of urolithiasis in Turkey II: role of metabolic syndrome components on urolithiasis

The components of metabolic syndrome, such as obesity, hypertension, and diabetes, are thought to be associated with urolithiasis. However, there are few large-scale studies that have examined the association between metabolic syndrome and urolithiasis, which prompted us to study and evaluate the relationship between metabolic syndrome components and urolithiasis in a nationwide survey, using the cross-sectional study conducted by a professional investigation company, with 2,468 enrolled participants, aged between 18 and 70 years, from 33 provinces in Turkey. Participants were interviewed face-to-face by medical faculty students. Participants with a history of urolithiasis (Group 1) were compared with participants without a history of urolithiasis (Group 2) in terms of hypertension, diabetes, body-mass index (BMI), waist size, and trouser size using Chi-square and odds ratio tests. Of the 2,468 participants, 274 (11.1%) reported a history of urinary stone disease diagnosed by a physician. The percentage of participants with hypertension along with urolithiasis was significantly higher than that in participants without urolithiasis (16.9 and 34.3%, p 0.000, OR 3.0). The percentage of participants with diabetes in groups 1 and 2 was 14.2 and 9%, respectively (p 0.001, OR 1.83). The mean BMI was 27.2 and 25.2, respectively (p 0.01). Participants with a BMI >30 had a 2.2-fold increased risk of having urolithiasis. The mean waist size was significantly greater in participants with urolithiasis (p 0.000). Those with a waist size >100 cm had a 1.87-fold increased risk of having urolithiasis. The mean trouser size was also significantly larger in those participants who were stone formers (p 0.003). The results indicate that metabolic syndrome components are important factors in the development of urolithiasis.     

Urolithiasis in infants: evaluation of risk factors

Objective

Urolithiasis in infants is not a very rare situation in Turkey, and the incidence has been increasing in recent years. The purpose of this paper was to investigate the clinical characteristics, metabolic and anatomic risk factors for urolithiasis and microlithiasis in infants.

Methods

The cases of 178 infants (63 girls, 115 boys), who were referred to our department between 1999 and 2009 with urolithiasis, were evaluated.

Results

The mean age at diagnosis of stone disease was 11.5 months (range, 10 days–24 months). The mean follow-up duration was 33.6 months (1.2–110 months). The major clinical symptoms of our patients were restlessness in 24 children (13.5%) and vomiting in 23 (13%). Thirty-five infants (19.7%) had a urinary tract abnormality; vesico-ureteral reflux was the most common abnormality (12.9%). Hypercalciuria and hyperuricosuria were detected in 46 and 56%, respectively. Stone analysis was performed in 56 infants, and calcium oxalate was determined in 36 patients (64.3%). A family history of urolithiasis, presenting symptoms and underlying metabolic abnormalities were similar for patients with microlithiasis and those with larger stones. However, infants with microlithiasis had higher ratios for history of vitamin D administration and feeding with formula. Surgical treatment was performed in 42 infants and extracorporeal shock wave lithotripsy in 30 infants.

Conclusion

Our results showed that urolithiasis in infants may present nonspecific symptoms and may even be asymptomatic and that a positive family history for urolithiasis, urologic abnormalities, metabolic disorders, urinary tract infections, vitamin D administration and feeding with formula may increase the occurrence of urolithiasis in infants.     

不同腔内方法治疗膀胱结石的疗效观察

目的：研究Punch碎石钳碎石和U100激光碎石治疗膀胱结石的安全性及有效性，并进一步比较两种碎石方法的有效性差异。方法：回顾性分析82例膀胱结石患者临床资料，其中Punch碎石钳碎石43例，U100激光碎石39例。结果：碎石成功率U100激光组（97．2％）较碎石钳组（62．8％）显著性增高，差异有统计学意义（P〈0．01）。直径在2．5cm以上结石，U100激光组较碎石钳组碎石效率及成功率均明显增高，差异有显著统计学意义（P〈0．05）。结论：对直径1．5cm以下结石，Punch碎石钳与U-100激光在碎石效果方面差异无统计学意义。对直径2．5cm以上结石，推荐首选U-100激光。U100激光碎石联合TURP是治疗BPH并膀胱结石的安全、有效的方法。