Department of Urology and Renal transplantation, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebreali Road, Lucknow 226014, U.P, India.
J Pediatr Urol. 2013 Dec;9(6 Pt A):825-30. doi: 10.1016/j.jpurol.2012.11.003. Epub 2013 Jan 21.
Pediatric urolithiasis can cause significant morbidity and damage to the kidney, or even renal failure. We review our experience of the management of urolithiasis in pediatric patients at a tertiary referral center.
We reviewed medical records of all children with urolithiasis who were diagnosed and managed at our center from August 2003 to October 2011. Management was planned according to stone burden and location. We noted and statistically analysed data about age, sex, stone burden, clinical features, management, metabolic abnormalities and recurrence.
There were 325 children with 378 stone sites. Age range was 3-17 (mean 8) years. The male to female ratio was 3:1. Most common presentation was abdominal pain in 257 children (79%), and the most common stone site was kidney in 215 (57%). Twenty-four (7%) children (stone burden ≤3 mm) were managed conservatively, while the rest received some form of intervention. Metabolic workup could be done in 154 (47%) children. A metabolic abnormality was seen in 67 (43%) children, normocalcemic hypercalciuria being the most common. Recurrence of urolithiasis was seen in 78 (24%) children after a mean follow-up of 3.2 (1-6) years, and was more common in those who had a metabolic abnormality or in whom small residual fragments were left in situ.
Availability of smaller instruments has led to safer use of percutaneous endoscopy and ureteroscopy in children, with results comparable to those in adults and an acceptable complication rate. The presence of a metabolic abnormality is quite common and is a cause of recurrence.
小儿尿石症可导致严重的发病率和肾脏损害，甚至肾功能衰竭。我们回顾了我们在三级转诊中心治疗小儿尿石症患者的经验。
我们回顾了 2003 年 8 月至 2011 年 10 月在我们中心诊断和治疗的所有小儿尿石症患者的病历。根据结石负担和位置规划治疗方案。我们记录并统计分析了年龄、性别、结石负担、临床特征、治疗、代谢异常和复发的数据。
共有 325 名儿童 378 个结石部位。年龄范围为 3-17 岁（平均 8 岁）。男女比例为 3:1。最常见的表现是 257 名儿童（79%）的腹痛，最常见的结石部位是肾脏的 215 名（57%）。24 名（7%）儿童（结石负担≤3mm）接受保守治疗，其余则接受某种形式的干预。154 名（47%）儿童进行了代谢检查。67 名（43%）儿童存在代谢异常，以正常血钙高钙尿症最为常见。在平均随访 3.2（1-6）年后，78 名（24%）儿童出现尿石症复发，在有代谢异常或结石残留在原位的儿童中更为常见。
较小器械的可用性使得经皮内窥镜和输尿管镜在儿童中的使用更安全，结果与成人相当，并发症发生率可接受。代谢异常较为常见，是复发的原因。
