儿童三聚氰胺结石8579例筛查结果回顾性分析

目的探讨服用三聚氰胺污染配方奶粉的儿童泌尿系结石以及肾积水的发生率，评价三聚氰胺对儿童泌尿系统的影响。方法2008-09～10在广西壮族自治区人民医院筛查三聚氰胺结石的儿童8579名，每例筛查儿童均有服用配方奶粉史。常规进行泌尿系统B超检查，观察是否发生泌尿系结石和肾积水。对超声检查阳性病例进行尿常规及血清BUN／Cr检测。结果超声检查发现阳性病例274例，其中泌尿系统结石173例，肾积水53例，肾盂分离49例，肾囊肿17例。重度肾积水5例住院治疗，其中1例发生肾功能衰竭，经治疗5例患儿均痊愈出院。结论三聚氰胺容易在婴幼儿泌尿系统形成泥沙样结石，造成肾盂输尿管连接部梗阻进而导致肾积水，严重者可影响肾功能。大量饮水可促进结石排出，解除梗阻情况；严重梗阻病例需要外科手术治疗来缓解长期肾功能损害。早期诊治是改善预后的关键。阳性病例建议超声随访，以利于监测病情变化。

Retrospective analysis of melamine stone screening in 8579 children

Objective To investigate the incidence of urinary tract stones and hydronephrosis in children fed with infant formula milk power contaminated with melamine, and evaluate the influences of melamine on children urinary system. Methods Totally 8 579 children fed with infant formula milk powder were screened for urinary stone using B-ultrasound method in the people＇ s hospital of Guangxi zhuang autonomous region from September to October 2008. Urine routing examination and serum BUN/Cr were conducted on those Ultrasound-positive cases. Results Ultrasound examination showed 274 positive cases ,including 173 cases of urinary calculi, 53 cases of hydronephrosis, 49 cases of renal pelvis separation, 17 cases of renal cysts. Five eases of severe hydronephrosis were hospitalized, 1 of which occurring renal failure. All these 5 patients were cured and discharged finally. Conclusion This study found that melamine easily forms sand-like urinary calculi in infants and young children. The obstruction of ureteropelvic junction could cause hydronephrosis, and in severe cases, affect kidney function. Hydration therapy could promote the stone discharging. Serious cases of obstruction may need surgical intervention to relieve the lung-term damage of renal function. Early diagnosis and treatment is the key to prognosis. Ultrasound follow-up should be suggested to positive eases to monitor hydronephrosis.