Yong Jiang,Zhao Yaowang,Wang Zhi,et al.Clinical features and treatments of lower urinary tract calculi in children[J].Journal of Clinical Pediatric Surgery,,():858-863.[doi:10.3760/cma.j.cn101785-202506006-010]
Clinical features and treatments of lower urinary tract calculi in children
- Keywords:
- Urinary Calculi; Symptoms and Signs; Postoperative Complications; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the clinical characteristics and treatments of children with lower urinary tract calculi in urinary system and provide practical references for clinical diagnosis and treatment. Methods Retrospective analysis was conducted for the relevant clinical data of 72 children hospitalized with lower urinary tract calculi from January 2017 to December 2023.Chief complaints, symptoms, signs, laboratory test results, imaging findings, surgical approaches, calculus composition types, postoperative follow-ups and recurrence status were collected.Based upon the location of calculi, they were divided into two groups of bladder and urethral calculi.Also they were assigned into four groups of time from symptom onset to hospital visit of ≤7 day (n=29), >7 day & ≤14 day (n=7), >14 day & ≤30 day (n=8) and >30 day (n=28).Statistical processing was performed. Results Among them, there were bladder calculi (n=53) and urethral calculi (n=19).There were 63 boys and 6 girls with a long diameter of calculi (12.0±7.4) mm and an average age of 38(25, 65) month; 19 cases (26.4%) had positive urine culture; time from symptom onset to visit 14(3, 112) day.Postoperative stone composition: 34 cases of calcium oxalate calculi (n=34), uric acid calculi (n=16), struvite (n=15), cystine calculi (n=4), xanthine calculi (n=1) and calcium hydrogen phosphate calculi (n=2).Long diameter of bladder calculi was larger than that of urethral calculi [(13.7±7.8) vs. (7.1±2.2)]; time from symptom onset to visit longer in bladder calculi group than that in urethral calculi group [30(4, 167) vs. 5(1, 17)]; postoperative urine pH value higher in bladder calculi group than that in urethral calculi group [6.5(6.0, 7.0) vs. 6.0(6.0, 6.5)]; postoperative C-reactive protein 2.8(1.0, 14.0) in bladder calculi group higher than that in urethral calculi group 1.1(0.8, 2.0); the differences were statistically significant (P < 0.05).No statistically significant differences existed in preoperative and postoperative blood routine leucocytes, neutrophils and C-reactive protein among four groups (P>0.05).Linear regression analysis was performed for examining the quantitative dependence relationship between time from symptom onset to visit and long diameter of calculi.The regression coefficient was 0.015 with an intercept of 10.196; regression coefficient hypothesis test: t=5.569, P < 0.001; regression coefficient variance analysis: F=31.018, P < 0.001; linear regression equation: ?=10.196+0.015x. Conclusions The typical symptoms of lower urinary tract calculi in children are urinary pain, difficulty urinating and hematuria.And the major components of calculi are calcium oxalate and uric acid.Greater attention should be paid to postoperative selecting perioperative antibiotic protocols.The onset of symptoms and the time of seeking medical attention may somewhat affect the length and diameter of calculus and early medical attention should be sought.
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Memo
收稿日期:2025-6-4。
基金项目:湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017)
通讯作者:赵夭望，Email: yw508@sina.com