目的：探讨应用头孢曲松钠不当导致泌尿系结石、急性肾功能衰竭的可行性治疗方案。方法分析本院自2010年1月至2013年6月收治的9例因应用头孢曲松钠不当导致泌尿系结石、急性肾功能衰竭患儿的临床资料。结果9例泌尿系彩超均提示双肾实质弥漫性回声增强，肾盏、肾盂及输尿管内见泥沙样强回声物。双侧6例，单侧3例。8例伴输尿管扩张、肾积水，1例无明显肾积水。X线检查均未见阳性结石显影。入院后均给予解痉及碱化尿液、护肾治疗，7例联合膀胱镜下输尿管逆行插管冲洗治疗，其中1例插管失败，行腹膜透析治疗。治疗1周，尿量稳定后复查泌尿系彩超，9例结石均消失。肾实质回声恢复正常，伴有肾、输尿管积水的患儿积水范围全部缩小或消失。结论应用头孢曲松钠不当可以导致小儿泌尿系统结石、急性肾功能不全或衰竭，解痉、碱化尿液，必要时辅以手术治疗可有效逆转肾功能损害，结石多能在尿量恢复正常后排出。%Objetive To investigate the treatment options that Ceftriaxone lead to urinary calculi and a-cute renal failure(ARF). Methods Analyze nine cases in our hospital that Ceftriaxone lead to urinary calculi and ARF in children from January 2010 to June 2013. Results Urinary tract ultrasonography were prompted that kidneys diffuse parenchyma echogenic,Calyx,renal pelvis and ureter be seen the sediment samples strong echo of substance,6 cases were bilateral,and 3 cases were unilateral.8 cases with ureteral dilatation and hydro-nephrosis.1 patient had no significant hydronephrosis.x-ray examination showed no positive stones develop-ment.All patients were given antispasmodic and alkaline urine,and kidney treatment after admission,seven pa-tients were combined retrograde ureteral cystoscope rinse surgery,including one case of failed intubation,perito-neal dialysis.After one week of treatment,the urine stable and reviewed the urinary tract ultrasonography,nine cases of children with stones disappeared.Renal parenchymal echo back to normal,accompanied by the kidney, ureter in children with hydrocephalus whole range of water shrink or disappear. Conclusion Improper applica-tion of the Ceftriaxone can cause urinary stones and ARF in children,timely antispasmodic,alkaline urine thera-py,and if necessary,surgical treatment can effectively reverse kidney damage,stones can be discharged after u-rine output returns to normal.
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