三聚氰胺泌尿系结石并急性肾衰竭婴幼儿的预后与转归  

Prognosis and Turnover of Infants with Acute Renal Failure Induced by Melamine-Related Urinary Stone

作　　者：文建国[1,2] 任川川[1] 娄安峰[1] 芦山[1] 王焱[1] 张艳[1] 毛淑平[1] 徐千雅[1] 姚亚雄[1] 杨黎 陈燕[1] 李真珍 文建军[1] 

机构地区：[1]郑州大学第一附属医院小儿尿动力学中心/泌尿外科/急救中心,郑州450052 [2]河南省高等学校临床医学重点学科开放实验室,郑州450052

出　　处：《实用儿科临床杂志》2011年第1期59-61,共3页Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划项目(200801002);郑州市技术研究与开发经费支持项目(074SGHH32262)

摘　　要：目的探讨三聚氰胺泌尿系结石(MUS)并急性肾衰竭(ARF)婴幼儿的预后与转归。方法对2008年7-10月在本院住院治疗的21例MUS并ARF婴幼儿[ARF组,年龄(10.5±5.7)个月]进行20个月随访。随访内容包括泌尿系超声、尿常规、肾功能检查,并记录其身高、体质量、临床症状及并发症情况。选取同期住院治疗的30例单纯MUS无ARF患儿(MUS组)及50例无三聚氰胺污染奶粉喂养史的健康儿童(健康对照组)作为对照。比较三组间相关参数异同。结果成功随访17例MUS并ARF患儿;经过保守治疗(其中12例患儿行血液透析),患儿恢复顺利,无临床症状及相关并发症,尿常规和肾功能检查未见明显异常。12例带结石出院患儿中结石消失7例、变小4例、无明显变化1例。8例出院时仍有肾积水的患儿中,5例消失;2例减轻,1例无明显变化。ARF组患儿出院带石率、结石消失率、出院积水率及积水消失率与MUS组比较差异均无统计学意义(Pa>0.05);AFR组和MUS组患儿及健康对照组儿童身高及体质量比较差异均无统计学意义(Pa>0.05)。结论 MUS并AFR患儿经过住院保守治疗(包括血液透析),ARF得以纠正,症状缓解,20个月随访显示预后与转归较好,生长发育无明显影响,未见泌尿系肿瘤形成。Objective To investigate the prognosis and outcome of acute renal failure（ARF） induced by melamine-related urinary stone（MUS） in infants.Methods Twenty months′ follow-up was performed in 21 infants with ARF induced by MUS（ARF group）,who were aged（10.5±5.7） months.Thirty children with MUS but without ARF（MUS group） and 50 healthy infants without the history of consuming melamine contaminated milk powder（healthy control group） were collected as controls.The age and gender had no significant difference among the 3 groups.Urinary ultrasonography,urinalysis and renal function tests were performed in all children,and the data of body weight,height,clinical signs,complications were collected.Results Seventeen children in ARF group were followed up successfully.After treated by conservative management（12 cases of them were performed with hemodialysis）.All showed a good recovery since discharged from hospital 20 months ago.The results of urinalysis and renal function tests were normal,ultrasonography showed normal urinary morphology.Twelve of them showed residual stones either in the kidney or ureter at the time of discharge,7 cases disappeared completely,4 cases dissolved partially,and 1 case did not change.Of the 8 infants with hydronephrosis at the time of discharge,1 case did not change,2 cases decreased in size,and others recovered to normal.The parameters regarding to the kidney morphology and function did not show significant difference between diffe-rent groups at the time of follow-up（Pa0.05）.The body weight and height between ARF group,MUS group and healthy control group did not show statistical significance（Pa0.05）.Conclusions After treated by conservative management including hemodialysis,the infants with ARF induced by MUS had shown a good prognosis.No effect on the body growth and development,and no urinary tumor was found at the time of 20 months after discharging from hospital.

关 键 词：三聚氰胺 泌尿系结石 急性肾功能衰竭 随访 婴幼儿 

分 类 号：R726.9[医药卫生—儿科]