误诊为泌尿系结核疾病的病因学分析  

Etiology Analysis of the Diseases Misdiagnosed as Urinary Tract Tuberculosis (Report of 6 Cases)

作　　者：金伟[1] 李如昌[1] 

机构地区：[1]复旦大学附属金山医院泌尿外科,上海200540

出　　处：《中国临床医学》2006年第1期124-125,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:分析误诊的原因和建立误诊为泌尿系结核疾病的病原学分类。方法:回顾分析复旦大学附属金山医院近30 年间6例误诊病例,皆经手术确诊。结果:依据被误诊的疾病,可分为4大类,肾脏先天性畸形2例,包括一侧肾不发育1 例,先天性肾盏积水继发结石1例;多源性尿路上皮原位癌1例,肾上盏尿路上皮癌1例;特殊的尿路结石病1例;肾出血性紫癜1例。结论:泌尿系影像资料看似结核的其他疾病易误诊为泌尿系结核,如先天性畸形,不常见的尿路上皮癌和泌尿系结石病。在泌尿系不典型结核的鉴别诊断中还应考虑内科肾脏出血性疾病。Objective： To analyze the causes of misdiagnosis and to establish the etiology classification of the diseases misdiagnosed as urinary tract tuberculosis. Methods： The medical records of 6 cases during the past 30 years were reviewed retrospectively. Results： According to etiology of the rnisdiagnosed diseases, 4 major categories were divided. Congenital anomalies of the Kidney were in 2 cases, including unilateral renal agenesis in 1, congenital hydrocalycosis of infundibulopelvic stenosis in 1. Multiple primary uroepithelial carcinoma in situ in upper and lower urinary tract in 1 case uroepithelial carcinoma in the upper pole calyx in 1, Exceptional urinary stone disease in 1 case.. Massive hematuria due to renal vascular purpura in l case. Condusion：Excessively depending on ,tuberculosis- like looking on the urinary tract, imaging studies were the pricipal reason for misdiagnosis. Congenital anomalies, unusual uroepithelial carcinoma and urinary stone disease, hematuria in some medical renal disease should be considered and supplemented in differential diagnosis of atypical urinary tract tuberculosis.

关 键 词：泌尿生殖系 结核 结石 肿瘤 畸形 

分 类 号：R527[医药卫生—内科学]