肾结核诊断与治疗  

Diagnosis and treatment of renal tuberculosis

作　　者：高中伟[1] 程远合[1] 陈望[2] 刘刚[1] 张梓锋[1] 苏德丽[1] 韩淑婷[1] 李静[1] 

机构地区：[1]河南科技大学第一附属医院泌尿外科,河南洛阳471003 [2]河南科技大学第一附属医院CT室,河南洛阳471003

出　　处：《中国现代医学杂志》2005年第16期2490-2492,共3页China Journal of Modern Medicine

摘　　要：目的探讨肾结核诊断与治疗。方法对46例肾结核患者的诊断及治疗进行回顾性研究。结果尿查抗酸杆菌、尿聚合酶链反应结核菌和血清抗结核特异性抗体的准确率分别为15.7%、50%和44%。B超、静脉肾盂造影、逆行性肾盂造影和CT准确率分别为24.2%、57.9%、66.7%和80.6%。单纯抗结核药物治愈11例。患肾切除32例,患肾造瘘、肾盂输尿管离断成型1例,输尿管膀胱再植入1例。扩大膀胱术1例。结论B超、静脉肾盂造影对肾结核的诊断缺乏特异性。聚合酶链反应结核菌、CT在肾结核诊断中起着越来越重要的作用。肾结核治疗仍以肾切除术为主要方法,同时应尽可能切除患侧输尿管。[Objective] To investigate the diagnosis and treatment of renal tuberculosis（RT）. [Methods] The documents of 46 cases of patients withRT were retrospectively reviewe. [Results] The positive rate of urine acidfast stains, polymerase chain reaction of tuberculosis（PCR-TB-DNA）, dserumPPD-IgG were, 15.7%, 50%, 44% respectively. The positive rate of ultrasonography, intravenousurography（IVU）, retrogradepyelography, computerized tomography（CT） were 24.2%, 57.4%, 66.7%, 80.6%, respectively. Antituberculosis chemotherapy was used in 11 cases of patients. Nephrectomy was was performed in 32 cases, nephrostomy in combination with dismembered pyeloplasty was performed in 1 case, Ureteroneocystostomy was performed in 1 case. Augmentation cystoplasty was performed in only 1 case. [Conclusions] Ultrasonography, IVU can not be regarded as a specific examination in diagnosing RT, PCR-TB-DNA and CT play more and more importment role in the diagnosis of RT. Nephrectomy is the main way in the treatment of RT, remove as much as possible of the ureter is required.

关 键 词：肾结核 诊断 治疗 

分 类 号：R527.1[医药卫生—内科学]