三聚氰胺污染奶粉致婴幼儿泌尿系结石体外冲击波治疗体会  

ESWL for infants with urinary lithiasis due to melamine tainted milk product

作　　者：梁军[1] 张伟[1] 马文强[1] 宋全斌[1] 陈金权[1] 李敬宁[1] 赵延斌[1] 

机构地区：[1]解放军第一医院泌尿外科,甘肃兰州730030

出　　处：《疑难病杂志》2011年第8期591-593,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨体外冲击波碎石治疗三聚氰胺所致婴幼儿泌尿系结石的疗效。方法对2008年6月—2009年12月收治的94例三聚氰胺污染奶粉所致婴幼儿泌尿系结石病例,经体外冲击波碎石及碎石后药物综合治疗,观察1～4周进行疗效评定。结果共治疗97枚结石,其中镇痛组(丁卡因凝胶局部涂擦组)18例患儿结石全部排净,结石清除率100%(18枚/18枚);镇静镇痛组(苯巴比妥钠+哌替啶组)30例患儿结石清除率63.3%(19枚/30枚);静脉全麻组(氯胺酮+咪达唑仑)46例患儿结石清除率85.7%(42枚/49枚),总的治愈率81.4%(79枚/97枚),余下18枚结石中,9枚结石治疗有效,体内遗留有≤4mm结石,9枚结石治疗无效。未观察到并发症。结论三聚氰胺所致婴幼儿泌尿系结石体外冲击波治疗是一种创伤及副损伤小,较为安全有效治疗方法 。Objective To summarize the experience with extracorporeal shock wave lithotripsy（ESWL） for the treatment of infants with urinary lithiasis due to melamine tainted milk product（MTMP）.Methods The authors reviewed the records of 94 infants admitted to the hospital for treatment of urinary lithiasis due to MTMP from June 2008 to December 2009. Ninety-seven stones were treated with ESWL under three different anesthesia methods and subsequent comprehensive drug treatment.Stone status was evaluated every week after lithotripsy within 4 weeks.Results There were 97 stones,the stonefree rates in relieve pain group（local inunction with tetracaine gel）,relieve pain plus sedation group（phenobarbital sodium combined with pethidine）and basal anesthesia group（ketamine combined with midazolam）were 100%（18/18 stones）,63.3% （19/30 stones） and 85.7%（42/49 stones） respectively.The total stone-free rate of the 97 stones was 81.4%（79/97 stones）.The partial response rates（asymptomatic fragments less than 4 mm） were 9.3%（9/97）.In spite of 4 courses of treatment,9 stones were unchanged and the inefficacy rate is 9.3%（9/97）.No complications were observed.Conclusion In infants suffering from urinary lithiasis associated with MTMP,ESWL proved to be safe and effective.

关 键 词：婴幼儿 体外冲击波碎石术 泌尿系结石 三聚氰胺 

分 类 号：R726.9[医药卫生—儿科]