肾结核临床诊断方法探讨  

Investigation the Diagnosis of Renal Tuberculosis

作　　者：张劲松[1] 张勇[2] 陈忠[2] 杨为民[2] 

机构地区：[1]湖北省黄冈市中心医院泌尿外科,湖北黄冈438000 [2]华中科技大学同济医学院附属同济医院泌尿外科

出　　处：《临床泌尿外科杂志》2011年第11期808-811,共4页Journal of Clinical Urology

摘　　要：目的:探讨肾结核的临床表现及诊断方法,提高早期诊断水平。方法:收集2000年10月～2009年10月收治1 36例肾结核患者的临床资料,对其病史特点及诊断方法进行回顾性分析。结果:136中男62例,女74例。常见临床症状依次为尿频尿急(59.6%)、尿痛(41.9%)、血尿(36.0%)和腰痛(36.0%)。尿常规异常率71.8%,尿沉渣找抗酸杆菌阳性率29.3%,PPD试验(纯结核菌素试验)阳性率86.7%,血结核蛋白芯片检测法阳性率88.3%。B超、KUB及IVU、CT、MRI、膀胱镜、活检以及输尿管逆行插管造影的阳性率分别为20.6%、10.3%、55.1%、51.7%、12.5%、22.6%、11.1%。结论:肾结核早期诊断困难,需要结合临床表现、实验室(结核蛋白芯片检测法阳性率最高)以及影像学检查(CT准确率最高)综合考虑。Objective： To investigate the clinical manifestations and diagnosis of renal tuberculosis （TB） and improve the early diagnosis ability of renal tuberculosis. Methods： The data collected from our hospital with 136 cases of renal tuberculosis patients＇ clinical materials from October 2000 to October 2009, retrospectively analyzed its history characteristics and diagnostic methods. Results：Renal tuberculosis was diagnosed in 136 patients which consisted of 62 males and 74 females. The most common presenting symptoms were frequency and urgency （59. 6%）, dysuria （41.9%）,gross hematuria （36%） and flank or back pain （36%）. Microscopic hematuria and/or pyuria were detected in 71.8% of the patients. The positive results of acid-fast stains on urinary sediment, PPD and tuberculosis protein chip were 29.3% ,86.7% and 88.3% respectively. The positive rate of KUB＋IVU, B-type ultrasonography, CT, MRI, cystoscopy, cystoscopy with biopsy and retrograde pyelography were 10. 3%,20. 6%,55.1%, 51.7%, 12.5%, 22.6%,11.1% respectively. Conclusions ： Since the earlier diagnosis of renal tubercu- losis is difficult to make, it＇s necessary to combine with analysis of clinical characteristics, laboratory examination （tuberculosis protein chip） and imageology examination（CT scan）.

关 键 词：结核 肾 不典型症状 诊断 

分 类 号：R692[医药卫生—泌尿科学]