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肾结核诊治分析(附52例报告)
引用本文:梁国标,沈寅初,罗旭,赵兴奇,李栋,陈宗平.肾结核诊治分析(附52例报告)[J].中华泌尿外科杂志,2004,25(1):15-17.
作者姓名:梁国标  沈寅初  罗旭  赵兴奇  李栋  陈宗平
作者单位:563003,贵州,遵义医学院附属医院泌尿外科
摘    要:目的 探讨肾结核的临床表现及诊治方法。 方法 肾结核患者 5 2例 ,临床表现膀胱刺激征 36例 (6 9% ) ,腰痛伴肉眼血尿 10例 (19% ) ,肾绞痛及无痛性肉眼血尿各 6例 (11% )。 5 2例中B超提示肾结核 2 0例 ,单侧肾积水 2 2例 ;4 7例肾图示患肾无功能 31例 ;同期尿AFB和Tb PCR检查38例 ,尿AFB阳性 13例 (34% ) ,尿Tb PCR阳性 2 1例 (5 5 % )。误诊为结石或炎症 2 7例。药物治疗 12例 (2 3% ) ,手术治疗 4 0例 (77% )。 结果  12例药物治疗者均痊愈。 4 0例手术后病理均诊断为肾结核 ,2 3例随访 1.5~ 5 .0年均治愈 ,发生输尿管残端综合征 5例。 结论 尿AFB和Tb PCR检查仍是术前确诊肾结核的主要手段。无功能结核肾切除同时应尽可能切除患侧输尿管。

关 键 词:结核    不典型表现  诊断  治疗学
修稿时间:2003年1月29日

Diagnosis and treatment of renal tuberculosis(report of 52 cases)
LIANG Guo-biao,SHEN Yin-chu,LUO Xu,et al..Diagnosis and treatment of renal tuberculosis(report of 52 cases)[J].Chinese Journal of Urology,2004,25(1):15-17.
Authors:LIANG Guo-biao  SHEN Yin-chu  LUO Xu  
Institution:LIANG Guo-biao,SHEN Yin-chu,LUO Xu,et al.Department of Urology,Affiliated Hospital of Zunyi Medical College,Guizhou 563003,China
Abstract:Objective To investigate the clinical manifestations,diagnosis and treatment of renal tuberculosis(TB). Methods This series included 52 patients with renal TB.Of them 36 cases (69%) presented with irritative symptoms.10 cases (19%) had lumbago accompanied by hematuria.6 cases (11%) had renal angina and 6(11%) painless hematuria.B-ultrasonography suggested renal TB in 20 cases and unilateral hydronephrosis in 22 cases;renogram showed that the diseased kidneys had no function in 31 cases.Urinal AFB and tuberculosis PCR(Tb-PCR) were performed in 38 cases,the results were positive in 13(34%)and 21(55%),respectively.27 cases were misdiagnosed to have calculi or inflammation.Treatments consisted of antituberculous chemotherapy in 12 cases (23%)and surgery in 40(77%). Results All of the 12 cases who received medications recovered completely.40 cases undergoing surgery were pathologically diagnosed to have renal TB;of them 5 cases developed ureteral stump syndrome. Conclusions Urine AFB and Tb-PCR remain the primary diagnostic methods before operation.When the non-functioning kidney is resected,the involved ureter should be concomitantly resected as much as possible.
Keywords:Tuberculosis  renal  Atypical symptoms  Diagnosis  Therapeutics
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