Clinical analysis of acute renal failure caused by urinary calculi obstruction in infants under the age of 6 months
10.3760/cma.j.issn.2095-428X.2017.23.010
- VernacularTitle:6月龄以下婴儿泌尿系结石梗阻导致急性肾衰竭临床分析
- Author:
Yidong HUANG
1
;
Li ZENG
;
Xue MA
;
Jie ZHANG
;
Miao YUAN
;
Lei KANG
;
Wei SHAN
;
Guizheng HUANG
;
gang Lu HUANG
Author Information
1. 四川大学华西医院小儿外科
- Keywords:
Urolithiasis;
Obstruction;
Renal failure,acute;
Treatment;
Hemodialysis;
Infants
- From:
Chinese Journal of Applied Clinical Pediatrics
2017;32(23):1793-1796
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively summarize the diagnosis and treatment experience of acute renal failure caused by urinary calculi obstruction in infants under the age of 6 months in order to improve the level of treat-ment. Methods Between January 2010 and December 2014,15 infants under the age of 6 months with bilateral urinary tract calculi obstruction leading to acute renal failure were treated in West China Hospital,Sichuan University. All cases were Tibetan(10 males,5 females). The ages ranged from 1 month 15 days to 5 months 24 days. The weights ranged from 3. 5 to 7. 0 kg. The clinical characteristics,treatment and clinical outcome were analyzed. Results A total of 9 infants(5 males,4 females)were assessed to be able to tolerate general anesthesia surgery and received positive conservative treatment before operation,and obstruction relief within 6 hours of admission. Six infants (5 males, 1 female)with serious internal milieu disorder,pneumonia,and shock,were assessed as critical cases,who could not tolerate general anesthesia surgery temporarily. Under the emergency blood purification support,they received anti -infection,spasmolysis,rehydration,to correct the internal milieu disorder and obstruction relief within 12 hours of admis-sion. Serum potassium,creatinine returned to normal 12 - 48 hours after obstruction relief. Stone specimens were obtained from 5 cases,and the stone compositions were calcium oxalate stone in 3 cases,calcium oxalate and carbonate apatite mixed stone in 2 cases. A total of 13 cases need further urolithiasis treatment. Conclusions The infants under the age of 6 months with bilateral urinary tract calculi obstruction are more severe with more complications. The emergency treatment principle is to save lives,then relieve the obstruction;surgery should be as brief as possible,since removing the stones is not the primary purpose. If the infants are in critical,life - threatening circumstances,and cannot tolerate general anesthesia surgery,the blood purification will be helpful to gain time and create conditions for treatment.
