Gosalbez R, Garat J M, Piro C, Martin J A
J Urol (Paris). 1980;86(9):665-70.
The authors report a series of 130 children suffering from urinary lithiasis (essentially between the age of 4 to 6 years) and particularly in boys (2.5 to 1). There were 108 cases of reno-ureteric lithiasis as against 23 vesico-urethral. In 69 cases, pyelocalyceal lithiasis predominated. Thirty per cent of the children had bilateral lithiasis, and 19% of all cases of lithiasis were staghorn calculi. Presenting symptoms : haematuria, diffuse abdominal pain, anuria (6 cases), complete urinary retention (5 cases). Study of these cases failed to indicate whether obstruction of the upper urinary tract (14%) or infection (27%) was the cause or the effect of the lithiasis. Particularly notable were 8 cases of cystinuria (6%), 1 of glycinuria, 1 of hyperoxaluria and 7 of hypercalciuria. At least in Spain, lithiasis in children would appear to be essentially idiopathic. However, 40% of these cases of lithiasis were secondary to obstruction of the excretory tract and/or urinary infection. All types of entero-uroplasty were lithogenic (6 cases). 32% of the children had a proteus infection. Treatment : 14 children were treated medically as against 125 surgically. 70% are free of any recurrence. 7% have a residual lithiasis. The rarity of recurrences and the quality of the results obtained indicate that complete surgical treatment represents the essential feature of the treatment of urinary lithiasis in children.
作者报告了130例患尿路结石的儿童(主要年龄在4至6岁之间),男孩尤为多见(男女比例为2.5比1)。肾输尿管结石有108例,膀胱尿道结石有23例。69例以肾盂肾盏结石为主。30%的儿童有双侧结石,所有结石病例中有19%为鹿角形结石。主要症状有:血尿、弥漫性腹痛、无尿(6例)、完全性尿潴留(5例)。对这些病例的研究未能表明上尿路梗阻(14%)或感染(27%)是结石的原因还是结果。特别值得注意的是8例胱氨酸尿症(6%)、1例甘氨酸尿症、1例高草酸尿症和7例高钙尿症。至少在西班牙,儿童结石似乎基本上是特发性的。然而,这些结石病例中有40%继发于排泄道梗阻和/或泌尿系统感染。所有类型的肠输尿管成形术都易形成结石(6例)。32%的儿童有变形杆菌感染。治疗方法:14名儿童接受药物治疗,125名接受手术治疗。70%的患儿无任何复发。7%有残余结石。复发罕见且治疗效果良好,这表明完全手术治疗是儿童尿路结石治疗的基本特征。