■尿石症是指尿路中存在矿物质沉积物。在5岁以下儿童和撒哈拉以南非洲,这种情况很少见。虽然50%的病例涉及代谢异常,感染,尿量和流量减少(脱水状态)已涉及。我们报告了一例患有腹泻病和脱水的婴儿的双侧输尿管结石。
■A.S,是一个8个月大的男性,长期松弛,大容量粪便,大量呕吐,高烧,身体虚弱,和眶周肿胀,进展为全身肿胀,并持续2天没有尿液。他有意识,无火(36.90摄氏度),脸色苍白。腹部有腹水。呼吸困难,粗糙的起皱,和低氧血症。心动过速(PR-180/min)高血压(BP-125/79mmHg)。PCV-20%,WBC-24,000/l,血小板-110,000/l。肌酐(1030umol/l),尿素——30mmol/l,多重耐药大肠杆菌双侧II级肾炎,输尿管积水肾病,右侧骨盆-输尿管和左侧膀胱-输尿管交界处结石。治疗腹泻病并发双侧输尿管结石继发的双侧梗阻性尿路病。进行了双侧开放输尿管探查,输尿管切开取石术,支架,术中输血,抗生素,镇痛药,IVF。术后24小时:尿量(3.26ml/kg/hr):右支架(210ml),左支架(423ml),导尿管(150ml),742umol/l,尿素:26mmol/l术后48小时:尿量5.1ml/kg/hr(1224ml/24hr);Cr:424umol/l,尿素:16mmo/l术后5天:尿量3.1ml/kg/hr(725ml/24hr);Cr:47umol/l,尿素:4.6mmo/l,患者已出院回家,目前正在儿科肾脏科和泌尿科诊所进行随访。
■在患有腹泻病的儿童中,高度怀疑阻塞性尿路病,脱水,建议患有急性肾损伤的人。
UNASSIGNED: Urolithiasis is the presence of mineral deposits in the urinary tract. It is rare in under-5 children and in Sub-Saharan Africa. Although metabolic abnormality is implicated in 50% of cases, infection, decreased urine volume and flow (dehydration state) have been implicated. We report a case of bilateral ureteric calculi in an infant with diarrhoea disease and dehydration.
UNASSIGNED: A.S, is an 8-month-old male with prolonged loose, large-volume stool, large-volume vomiting, high-grade fever, body weakness, and peri-orbital swelling that progressed to generalized body swelling and absent urine for 2 days. He was conscious, afebrile (36.90C), pale with anasarca. Had distended abdomen with ascites. Dyspnea, coarse crepitation, and hypoxemia. Tachycardia (PR -180/min) Hypertensive (BP - 125/79mmHg). PCV - 20%, WBC - 24,000/l, platelet - 110,000/l. Creatinine (1030 umol/l), Urea - 30mmol/l, Multi drug resistant E.Coli. Bilateral Grade II nephritis, hydro-uretero-nephrosis, right pelvi-ureteric and left vesico-ureteric junction calculi. Managed for Diarrhoea disease complicated with Bilateral Obstructive uropathy secondary to Bilateral Ureteric Calculi. Had bilateral open ureteric exploration, ureterolithotomy, Stenting, intraoperative transfusion, antibiotics, analgesics, and IVF. 24-hr post-surgery: urine output (3.26ml/kg/hr): right stent (210ml), left stent (423ml) while urethral catheter (150ml), 742umol/l, Urea: 26mmol/l 48-hr post-surgery: Urine output 5.1ml/kg/hr (1224ml/24hr); Cr: 424umol/l, Urea: 16mmo/l 5 days post-surgery: Urine output 3.1ml/kg/hr (725ml/24hr); Cr: 47umol/l, Urea: 4.6 mmo/l, Patient was discharged home and currently on follow-up in paediatric nephrology and urology clinics.
UNASSIGNED: A high index of suspicion of obstructive uropathy in children with diarrhoea disease, and dehydration, who have developed acute kidney injury is recommended.