论文部分内容阅读
目的分析三聚氰胺污染奶粉喂养儿童泌尿系统结石并发症的特点及其高危因素。方法回顾性分析163例食用三聚氰胺污染奶粉致泌尿系统结石患儿的临床资料,根据有无并发症,分为并发症组和无并发症组;进一步将存在并发症的患儿分为肾衰竭组、尿路梗阻组和尿路感染组。同时,选取纯母乳喂养泌尿系统结石有并发症的患儿20例作为对照组。比较各组相关参数变化。结果 41.0%(67例)的泌尿系统结石患儿出现并发症,其中肾衰竭占9.8%(16例),尿路梗阻占25.8%(42例),尿路感染占5.5%(9例)。并发症组血尿酸(SUA)显著高于无并发症组和对照组,而尿pH值显著低于上述2组,结石位置与无并发症组比较差异有统计学意义,结石形态、结石数目与对照组比较差异均有统计学意义(Pa<0.05)。肾衰竭组患儿年龄显著低于尿路梗阻组和尿路感染组(P<0.05),食用奶粉时间与上述2组比较差异无统计学意义(P>0.05)。肾衰竭组中双肾积水占62.5%(10例),主要表现为无尿(81.3%,13例)、少尿(18.7%,3例)。尿路梗阻组中上尿路梗阻占85.7%(36例),下尿路梗阻占14.3%(6例),其中无临床症状者占47.6%(20例),血尿7.1%(3例),排尿困难占14.3%(6例),腹痛占31.0%(13例)。尿路感染组主要表现为发热、血尿(66.7%,6例),尿频、尿急(22.2%,2例)。结论三聚氰胺污染奶粉喂养儿童泌尿系统结石并发症具有自身的发病特点,SUA、尿pH值和结石位置与并发症发生有关,年龄较小者易并肾衰竭。
Objective To analyze the characteristics and risk factors of complications of urinary system calculi fed by melamine-contaminated milk powder in children. Methods A retrospective analysis of 163 cases of children with urinary tract calcification caused by melamine-contaminated milk powder clinical data, according to the presence or absence of complications, divided into complications and no complications; further complications of the children were divided into renal failure group , Urinary tract obstruction group and urinary tract infection group. In the meantime, 20 cases of complication of pure breast feeding urinary system stones were selected as the control group. Compare the changes of relevant parameters in each group. Results Complications were found in 41.0% (67 cases) of urolithiasis, of which renal failure accounted for 9.8% (16 cases), urinary tract obstruction 25.8% (42 cases) and urinary tract infection 5.5% (9 cases). Complication group, serum uric acid (SUA) was significantly higher than the non-complication group and the control group, while the urine pH value was significantly lower than the above two groups, the stone position and non-complication group was significantly different, the stone morphology, The difference between the control group was statistically significant (Pa <0.05). The age of children with renal failure group was significantly lower than that of urinary tract obstruction group and urinary tract infection group (P <0.05). There was no significant difference in the time of eating milk powder between the two groups (P> 0.05). Kidney failure group, 62.5% (10 cases), mainly showed no urine (81.3%, 13 cases), oliguria (18.7%, 3 cases). Upper urinary tract obstruction accounted for 85.7% (36 cases) and lower urinary tract obstruction (14.3%) in urinary tract obstruction group (6 cases), of which 47.6% (20 cases) had no clinical symptoms and 7.1% (3 cases) Dysuria accounted for 14.3% (6 cases) and abdominal pain (31.0%) (13 cases). Urinary tract infection group mainly manifested as fever, hematuria (66.7%, 6 cases), urinary frequency, urinary urgency (22.2%, 2 cases). Conclusion Melamine-contaminated milk powder feeding complications of urinary tract stones have their own characteristics of onset, SUA, urinary pH and location of stones associated with complications, younger patients with renal failure and renal failure.