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目的评价三聚氰胺致婴幼儿泌尿系统结石保守治疗的疗效,为临床诊治提供参考。方法收集2008年4-12月甘肃省20家医院行保守治疗的68例泌尿系统结石患儿(男42例,女26例)的临床资料、实验室检查、超声结果,对其进行为期1a的随访调查,同时行双肾B超、肾功能检查(包括BUN、Cr、尿酸、α1-微球蛋白、微量清蛋白、β2-微球蛋白)及尿常规检查,进行治疗前与治疗1a后的对照研究。另选取82例健康婴幼儿作为健康对照组,行以上检查,且与治疗组1a后的结果进行比较。结果进行保守治疗共68例。其中14例(21%)无效改为外科治疗;54例保守治疗患儿随访1a,痊愈51例(75%,51/68例),3例(4%,3/68例)残留结石。患儿治疗前与治疗1a后B超检查结果比较差异有统计学意义(P<0.05)。治疗1a后尿红细胞水平高于健康对照组(P<0.05);肾功能检查各项指标治疗前与治疗1a后比较,治疗1a后与健康对照组比较,差异均无统计学意义(Pa>0.05)。结论三聚氰胺致泌尿系统结石患儿保守治疗效果较好,长期观察对肾功能无明显影响。
Objective To evaluate the efficacy of conservative treatment of urinary stones caused by melamine in children and adolescents, and provide reference for clinical diagnosis and treatment. Methods The clinical data, laboratory tests and ultrasound findings of 68 patients with urinary tract stones (42 males and 26 females) conservatively treated in 20 hospitals in Gansu Province from April to December in 2008 were collected. Follow-up survey, while B ultrasound, renal function tests (including BUN, Cr, uric acid, α1-microglobulin, trace albumin, β2-microglobulin) and urine routine examination before treatment and after treatment 1a Control study. In addition, 82 healthy infants were selected as healthy control group. The above examinations were performed and compared with that of the treatment group 1a. The results of conservative treatment of a total of 68 cases. Among them, 14 cases (21%) were ineffective and were treated surgically. Fifty-four patients with conservative treatment were followed up for 1a, 51 cases were cured (75%, 51/68) and 3 (4%, 3/68) residual stones. There was a significant difference in the results of B-ultrasound between children before treatment and after treatment 1a (P <0.05). The level of urinary erythrocytes was higher in the control group than in the control group (P <0.05). The indices of renal function test before treatment and after treatment la were not significantly different from those in the healthy control group (Pa> 0.05 ). Conclusion Melamine urinary tract stones in children with conservative treatment is better, long-term observation of renal function had no significant effect.