Aggour Ashraf, Ziada Ali M, AbdelHamid Ahmad Z, AbdelRahman Sherif, Morsi Ahmad
Department of Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.
J Pediatr Urol. 2009 Apr;5(2):132-5. doi: 10.1016/j.jpurol.2008.11.002. Epub 2008 Dec 6.
The composition of urinary stones in children depends on socioeconomic conditions, geography and dietary habits. Pediatric urolithiasis remains endemic in developing countries. The aim of this study was to analyze stone composition in an Egyptian patient population.
We analyzed prospectively urinary stones from 100 consecutive children (73 males, 27 females), aged 14 months to 12 years. The stones were located in the upper urinary tract in 78%, lower urinary tract in 19% and both in 3%. Male patients had more lower urinary tract stones. On presentation 67% had flank pain and 37% had hematuria. Stones were treated by open surgery in 69% of patients, shockwave lithotripsy in 20% and endoscopic extraction in 13%.
The components of the upper urinary tract calculi were calcium oxalate (47%), ammonium acid urate (26%) and calcium carbonate (21%), whereas the main components of the lower urinary tract calculi were ammonium acid urate (27.2%), struvite (27.2%) and calcium carbonate (22.7%). Urinary tract infection was involved in the development of one third of the stones. Endemic stones were present in 17% of patients, and stones of metabolic origin in 15%. The etiology of stone formation remained unknown in one third of patients.
The epidemiological profile of urinary stones in Egyptian children can now be considered intermediate between developing countries where dietary deficiencies are the main causes and developed countries where infectious and metabolic calculi are observed.
儿童尿路结石的成分取决于社会经济状况、地理位置和饮食习惯。小儿尿石症在发展中国家仍然是地方病。本研究的目的是分析埃及患者群体中的结石成分。
我们前瞻性地分析了100例连续儿童（73例男性，27例女性）的尿路结石，年龄在14个月至12岁之间。78%的结石位于上尿路，19%位于下尿路，3%上下尿路均有。男性患者下尿路结石更多。就诊时，67%有胁腹痛，37%有血尿。69%的患者通过开放手术治疗结石，20%采用冲击波碎石术，13%采用内镜取石术。
上尿路结石的成分是草酸钙（47%）、尿酸铵（26%）和碳酸钙（21%），而下尿路结石的主要成分是尿酸铵（27.2%）、磷酸镁铵（27.2%）和碳酸钙（22.7%）。三分之一的结石形成与尿路感染有关。17%的患者有地方性结石，15%有代谢性结石。三分之一患者的结石形成病因仍不明。
埃及儿童尿路结石的流行病学特征现在可被认为介于饮食缺乏是主要病因的发展中国家和观察到感染性及代谢性结石的发达国家之间。
