Schwarz Robert D, Dwyer Neil T
IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Urology. 2006 Apr;67(4):812-6. doi: 10.1016/j.urology.2005.10.020. Epub 2006 Mar 29.
To determine the specific risks for recurrent stone disease and which initial evaluations resulted in an effective reduction of risk, we undertook a long-term follow-up study of children who had experienced upper tract urinary stones.
Identified patients were contacted and interviewed using a structured questionnaire. The patient data were subcategorized and analyzed.
The results demonstrated that our population had a recurrence rate similar to the reported adult stone recurrence rates. No evidence was found of impaired growth or development. Our population of noncircumcised boys did not demonstrate a high risk of struvite stones. Surgical techniques have evolved. Anatomic and metabolic factors were not a predictor of an adverse risk of recurrence. Cystinuria may carry extra risk, although our numbers were not sufficient to be sure.
Extensive metabolic screening of children with upper tract urinary stones is not supported by the data from our patients. Testing for cystinuria is justified. The principles of screening and surveillance should match the recommended care of adults with stone formation.
为了确定复发性结石病的具体风险以及哪些初始评估能有效降低风险，我们对曾患过上尿路尿石症的儿童进行了一项长期随访研究。
使用结构化问卷对确诊患者进行联系和访谈。对患者数据进行分类和分析。
结果表明，我们研究人群的复发率与已报道的成人结石复发率相似。未发现生长或发育受损的证据。我们未行包皮环切术的男孩人群中，鸟粪石结石风险不高。手术技术已经发展。解剖和代谢因素并非复发不良风险的预测指标。胱氨酸尿症可能存在额外风险，尽管我们的病例数不足以确定。
我们患者的数据不支持对上尿路尿石症患儿进行广泛的代谢筛查。对胱氨酸尿症进行检测是合理的。筛查和监测原则应与推荐的成人结石形成护理相匹配。
