三聚氰胺所致婴幼儿尿路结石的微创外科治疗

目的 总结三聚氰胺所致婴幼儿尿路结石的微创外科治疗经验. 方法 回顾性分析36例三聚氰胺所致尿路结石患儿资料.男23例,女13例.年龄8～36个月,平均15个月.患儿均有受三聚氰胺污染奶粉喂养史,喂养时间为6～12个月.上尿路结石左侧11例、右侧6例、双侧18例,合并尿道结石4例,单纯膀胱结石1例.分别采用微创经皮肾镜碎石(MPCNL)5例、输尿管镜下碎石14例,输尿管支架管置入17例治疗. 结果 36例患儿均顺利完成手术.无大出血、穿孔或周围脏器损伤等严重并发症.术后住院3～10 d.患儿随访1～12个月,结石无复发,肾盂、输尿管积水消失或减轻,生长发育良好. 结论 微创内镜外科手术可以安全、有效地治疗三聚氰胺所致婴幼儿尿路结石,尤其适用于引起尿路梗阻的结石.

Minimally invasive surgical procedures treated urinary calculi caused by melamine in infants

Objective To report experience of minimally invasive surgery of urinary calculi caused by melamine in infants. Methods Retrospectively reviewed the treatments and outcomes of 36 cases with urinary calculi caused by melamine from November 2007 to October 2008. 13 girls and 23 boys aged 8 to 36 months after daily consumption for six month or more of milk products tainted with melamine. These infants underwent MPCNL, ureteroscopic lithotripsy and placement of ureteral stent, respectively. Results The operations were performed successfully in all patients. Five cases underwent MPCNL. Ureteroscopic lithotripsy were performed in fourteen cases. Seventeen cases were placed of ureteral stents. No major complications like hemorrhea, perforation and organic injury were noted. The postoperative hospital stays were 3 to 10 days. All cases were followed up for 1 to 12 months. Calculus had no recurrence. Hydronephrosis and hydroureterosis disappeared or lightened. Growth and development were normal. Conclusions Various kinds of minimally invasive surgical procedures is safe and effective treatments for urinary calculi caused by melamine in infants, applicable in calculi with urinary obstruction especially.