Steele B T, Lowe P, Rance C P, Hardy B E, Churchill B M
Int J Pediatr Nephrol. 1983 Mar;4(1):47-52.
One hundred and nine children with urinary tract calculi were reviewed and in some cases reinvestigated. Eighteen children had lower urinary tract calculi, which in all cases were associated with an underlying urodynamic abnormality. Sixty percent of 91 children with upper urinary tract calculi could be classified into 4 similarly sized etiological groups: an underlying urodynamic abnormality; urinary tract infection without a urodynamic abnormality; metabolic disorders; idiopathic hypercalciuria. An underlying abnormality was not found in 32% of cases. A painless presentation occurred in 39% of those with upper tract calculi. A family history of urinary calculi occurred in approximately one-half of children with either an idiopathic calculus or a calculus associated with cystinuria or idiopathic hypercalciuria. We conclude that urinary tract calculi, though rare in children, require extensive investigation to rule out urodynamic, infective and metabolic abnormalities. If such abnormalities are not found, the recurrence rate in the remainder is small and conservative treatment can usually be recommended.
对109例尿路结石患儿进行了回顾性研究，部分患儿进行了再次检查。18例患儿患有下尿路结石，所有病例均伴有潜在的尿动力学异常。91例上尿路结石患儿中有60%可分为4个规模相近的病因组：潜在的尿动力学异常；无尿动力学异常的尿路感染；代谢紊乱；特发性高钙尿症。32%的病例未发现潜在异常。上尿路结石患儿中39%表现为无痛性。约一半患有特发性结石或与胱氨酸尿症或特发性高钙尿症相关结石的患儿有尿路结石家族史。我们得出结论，尿路结石在儿童中虽罕见，但需要进行广泛检查以排除尿动力学、感染和代谢异常。如果未发现此类异常，其余患儿的复发率较低，通常可推荐保守治疗。
