肾结核97例临床分析  

Clinical study of 97 cases of renal tuberculosis

作　　者：蒋小雷[1] 吴运军[1] 孙凌[1] 吴明辉[1] 

机构地区：[1]川北医学院附属第二医院泌尿外科,四川绵阳621000

出　　处：《现代医药卫生》2008年第10期1439-1440,共2页Journal of Modern Medicine & Health

摘　　要：目的:总结分析肾结核的临床表现及诊治方法。方法:回顾性分析97例肾结核病例的临床资料。结果:膀胱刺激征、血尿和腰痛是最常见的症状。尿AFB和Tb-PCR检查阳性率分别为42.2%和71.1%。B超、IVU和CT的诊断阳性率分别为23.1%、71.1%和84.8%,本组中37例患者行药物治疗(异烟肼+利福平+吡嗪酰胺三联治疗,疗程9～12月),其中32例痊愈,65例行患肾及输尿管切除术。结论:尿AFB和Tb-PCR检查可使临床不典型肾结核诊断阳性率得到很大程度提高,IVU是肾结核诊断的首选影像学检查,CT对可疑病例的诊断具有辅助价值。无功能结核肾行肾切除术时应尽可能切除患侧的输尿管。Objective ：To study the clinical manifestations, diagnosis and treatment of renal tuberculosis （TB）.Methods：A retrospective study was made in 97 cases.Results：Irritation symptoms,hematuria and lumbodynia were the most common symptoms.The positive results of urinal AFB and TB-PCR were 42.2% and 71.1% respectively. The diagnostic accuracy of B-type ultrasonography,IVU and CT were 23.1% ,71.1% and 84.8% respectively. 32 of 37 cases were cured with medicine （INH＋RFP＋PZA for 9-12 months）.Nephroureterectomy was performed for 65 cases. Conclusion： Urinal AFB and TB-PCR would help to assess the diagnosis of renal TB ,especially in atypical cases. IVU is the first choice for diagnosis and CT scan is helpful. When the non-functioning kidney is resected,the involved ureter should be concomitandy resected as much as possible.

关 键 词：结核 肾 诊断 治疗 

分 类 号：R6[医药卫生—外科学]