67例不典型肾结核临床及影像学分析  

Clinical and imaging analysis of 67 atypical renal tuberculosis cases

作　　者：魏旭[1] 赵志清[2] 尹永华[1] 夏安[1] 

机构地区：[1]广州医科大学附属深圳沙井医院泌尿外科,518104 [2]广州医科大学附属深圳沙井医院放射科,518104

出　　处：《中国实用医药》2015年第31期4-6,共3页China Practical Medicine

基　　金：深圳市宝安区科技局科技计划项目资助(项目编号:2012140)

摘　　要：目的探讨不典型肾结核的临床及影像学特征。方法回顾性分析67例不典型肾结核患者的临床及影像学资料。结果 67例不典型肾结核患者行静脉尿路造影检查,发现阳性改变64例(95.5%)。67例患者行B超检查,发现阳性改变59例(88.1%),其中明确诊断者15例(22.4%)。67例患者行CT检查47例,CT诊断准确42例(89.4%)。尿常规异常者57例,连续3 d留尿找结核杆菌者60例,其中阳性者23例(38.3%),血沉加快者28例(41.8%)。67例患者经药物治疗的患者13例,经手术治疗的患者54例,治疗效果均满意。结论影像学检查对诊断肾结核具有非常重要的意义,螺旋CT检查对肾结核的诊断具有越来越重要的临床价值。对早期不典型肾结核完全可通过药物治愈,但对中、晚期不典型肾结核,肾切除术仍是主要治疗手段。Objective To investigate clinical and imaging characteristics of atypical renal tuberculosis. Methods A retrospective analysis was made on clinical and imaging data of 67 atypical renal tuberculosis patients.Results Those 67 cases with atypical renal tuberculosis received intravenous urography examination, which showed 64 cases with positive changes （95.5%）. They received B ultrasound examination, and there were 59 cases with positive changes （88.1%）, along with 15 clearly diagnosed cases （22.4%）. 47 cases among 67 cases received CT examination, and there were 42 cases with accurate diagnosis （89.4%）. There were 57 cases with abnormal urine routine and 60 cases with mycobacterium tuberculosis detection in urine for continuous 3 d. Among them, 23 cases were positive （38.3%） and 28 cases had quickened erythrocyte sedimentation rate （41.8%）. There were 13 cases receiving drug therapy and 54 cases receiving surgical treatment in the 67 cases. They all got satisfactory effects.Conclusion Imaging examination contains highly important significance for diagnosis of renal tuberculosis, and spiral CT provides increasingly important clinical value. Early atypical renal tuberculosis can be cured completely by drug medication measures, while moderate and advanced atypical renal tuberculosis still require nephrectomy as main treatment method.

关 键 词：肾结核 临床 影像学 

分 类 号：R527.1[医药卫生—内科学]