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   半岛家园：亲子乐园 > [育儿心得]小儿肾结石的若干问题
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    • 字体大小：小中大 发表于：2011-12-04 12:16
    小儿肾结石的若干问题
    <P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">    近日来因服用三鹿奶粉导致肾结石的事件，引起了消费者的普遍关注，有些妈妈非常困惑，他们从来没有给宝宝喂过有问题的奶粉，为什么他们的宝宝也得了肾结石呢？网上消费者讨论地非常热烈。其实引起肾结石的原因很多也很复杂。</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman"> </FONT></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">    简言之，尿液是一种复合性溶液，尿液中离子浓度及酸碱度的改变，可使一些难以溶解的盐类如草酸盐、磷酸盐、尿酸盐等呈过饱和状态而生成结晶体，若不及时随尿液排出，久之则沉淀、凝集而成结石。</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman"> </FONT></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">    小儿尿路结石的发病率显较成人为少，儿童约占</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">3%</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">左右，</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">3</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">岁以下的婴幼儿肾结石更为罕见。另一项在美国进行的回顾性的研究表明，在过去的</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">10</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">年（</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">1994</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">至</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">2005</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">），儿童肾结石的发病率升高了</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">5</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">倍。</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman"> </FONT></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">    肾结石的病因有：<BR><BR></SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt 42.75pt; TEXT-INDENT: -42.75pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: Arial; mso-fareast-font-family: Arial"><SPAN style="mso-list: Ignore"><FONT size=3>    </FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">液体摄入量不足。<BR></SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´"><BR>    液体摄入的量直接影响到尿液的量。液体摄入量少，尿液形成的量也少，这就增加了钙、草酸等物质在尿液中的浓度。增加液体的摄入对于那些有肾结石病史的儿童，可以明显降低复发的机会。而且，美国的儿科医生发现，夏天和秋天就诊的结石病人较多，这与天气热、干燥而导致的身体缺水有关。</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman"> </FONT></SPAN></P><P style="MARGIN: 0cm 0cm 0pt 42.75pt; TEXT-INDENT: -42.75pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: Arial; mso-fareast-font-family: Arial"><SPAN style="mso-list: Ignore"><FONT size=3>    </FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">高动物蛋白饮食。<BR></SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´"><BR>    高动物蛋白饮食（牛肉，猪肉，羊肉和鸡）的儿童发生肾结石的风险明显升高，尤其对于那些肠道吸收功能不良的儿童。但是，蛋白质正常的摄入是满足生长和发育所必须的，不会增加肾结石的风险。所以，均衡膳食很重要。</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman"> </FONT></SPAN></P><P style="MARGIN: 0cm 0cm 0pt 42.75pt; TEXT-INDENT: -42.75pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: Arial; mso-fareast-font-family: Arial"><SPAN style="mso-list: Ignore"><FONT size=3>    </FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">小儿泌尿系统异常。<BR></SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´"><BR>    主要是指泌尿道有梗阻性畸形存在，例如光天性肾盂、输尿管连接处梗阻（</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">PUJO</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">）</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">,</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">膀胱输尿管（</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">VUR</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">）返流等，又如肾重复畸形、输尿管囊肿等易诱发尿路感染，从而构成了形成尿结石的有利条件。</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman"> </FONT></SPAN></P><P style="MARGIN: 0cm 0cm 0pt 42.75pt; TEXT-INDENT: -42.75pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: Arial; mso-fareast-font-family: Arial"><SPAN style="mso-list: Ignore"><FONT size=3>    </FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">代谢性疾病<BR></SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 6pt; mso-char-indent-count: .5"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´"><BR>    代谢性疾病如甲状腺和甲状腺功能紊乱有关，但大多发生于青少年时代。</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman"> </FONT></SPAN></P><P style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; mso-list: l0 level1 lfo1; tab-stops: list 0cm"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: Arial; mso-fareast-font-family: Arial"><SPAN style="mso-list: Ignore"><FONT size=3>    </FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">遗传性疾病<BR></SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></P><P style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; mso-list: l0 level1 lfo1; tab-stops: list 0cm"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: Arial; mso-fareast-font-family: Arial"><SPAN style="mso-list: Ignore"><FONT size=3><BR></FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´"> 遗传性疾病是酶缺乏形成的尿路结石，如丙氨酸</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">-</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">乙醛转氯酶和</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">D-</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">甘油脱氢酶等，多发生于</SPAN><SPAN style="FONT-SIZE: 12pt"><FONT face="Times New Roman">2-3</FONT></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">岁幼儿。<BR></SPAN><SPAN style="FONT-SIZE: 12pt"><BR></P><P style="MARGIN: 0cm 0cm 0pt"><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">    上海交通大学医学院附属新华医院</SPAN><FONT size=3><SPAN style="FONT-SIZE: 12pt"><SPAN style="mso-spacerun: yes"><FONT face="Times New Roman">  </FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">儿科教授</SPAN><SPAN style="FONT-SIZE: 12pt"><SPAN style="mso-spacerun: yes"><FONT face="Times New Roman">  </FONT></SPAN></SPAN><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: 宋体; mso-ascii-font-family: ´Times New Roman´; mso-hansi-font-family: ´Times New Roman´">李衷初</SPAN><SPAN style="FONT-SIZE: 12pt"></SPAN></FONT></P></SPAN>
     
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