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目的探讨体外冲击波碎石(ESWL)治疗三聚氰胺致婴幼儿肾鹿角形结石的效果和副作用。方法采用DornierCompactDeltaⅡ型碎石机ESWL治疗婴幼儿鹿角形结石22例。年龄10～36个月,平均(22.9±6.3)个月。身长68～100cm,平均(80±7.3)cm。体重7～16.5kg,平均(12.0±2.6)kg。采用超声或X线定位。冲击次数300～1500次,工作电压8～12kV。结果 22例肾结石1次治愈11例(50%),2次9例(40.45%),1例(4.54%)多发性右肾结石效果不明显改成经皮肾镜取石术(PCNL)治疗,残石1例(4.54%)。3个月结石排净率为90.91%。所有患儿麻醉苏醒后耐受良好,无石评定时间平均24.68d。无严重并发症。20例(90.90%)术后有1～3次肉眼血尿。3例出现石街,长度1.9～4.3mm,经再次ESWL碎石成功。结论 ESWL治疗三聚氰胺致婴幼儿鹿角形结石的方法是安全的、有效的。建议身长<100cm患儿ESWL治疗时,辅助合理的托扶姿势以配合超声跟踪定位较精确,36个月以下的婴幼儿采用成人治疗剂量的1/8～1/6。
Objective To investigate the effect and side effects of extracorporeal shock wave lithotripsy (ESWL) in the treatment of melatonin-induced calculi in infants with melamine. Methods Twenty-two cases of antlers were treated with ESWL by DornierCompact Delta II lithotripsy machine. Aged 10 to 36 months, with an average of (22.9 ± 6.3) months. Length 68 ~ 100cm, with an average (80 ± 7.3) cm. Body weight 7 ~ 16.5kg, average (12.0 ± 2.6) kg. Using ultrasound or X-ray positioning. Impact times 300 ~ 1500 times, working voltage 8 ~ 12kV. Results The results of 22 cases of renal stone were cured in 11 cases (50%), 2 times in 9 cases (40.45%) and in 1 case (4.54%) with multiple right kidney stones were not changed to percutaneous nephrolithotomy (PCNL) , Residual stone in 1 case (4.54%). Three months stone discharge rate was 90.91%. All children were well tolerated after anesthesia awakening, and the average time for non-stone assessment was 24.68 days. No serious complications. 20 cases (90.90%) 1 to 3 times after the gross hematuria. Stone Street appeared in 3 cases, the length of 1.9 ~ 4.3mm, by ESWL again gravel success. Conclusions ESWL is safe and effective for the treatment of infant antlers with melamine. Recommended height <100cm pediatric ESWL treatment, supporting reasonable care posture to track with ultrasound more accurate positioning, infants and children 36 months of age adult doses of 1/8 ~ 1/6.