30例晚期肾结核患者诊断分析

目的：探讨晚期肾结核的发病原因及其诊断方法。方法：回顾性分析30例经病理学诊断的晚期肾结核患者的临床症状、实验室检查和影像学检查结果。结果：临床症状表现为膀胱刺激症状(90．00％)．血尿(66．67％)，腰痛(26．67％)。病程不超过半年者7例(23．33％)．其中5例患肾功能已丧失。实验室检查尿常规100％(30／30)结果异常．红细胞沉降率81．82％(18／22)异常升高．结核杆菌及其抗体检测阳性率偏低。静脉尿路造影57．14％(16／28)患侧不显影。B超检查均提示患肾积水、结构紊乱等改变。结论：肾结核临床症状不典型以及部分患者的早期隐匿无症状，是导致晚期肾结核发生的重要原因。肾结核的正确诊断首先有待于临床上对其临床特点及其不典型的变化趋势有足够的认识和警惕．其次是应对临床症状、实验室检查及影像学检查结果进行综合分析。

Diagnostic analysis of 30 cases advanced renal tuberculosis

Objective:To study the cause and diagnosis of advaced renal tuberculosis.Method:A retrospective study was made on 30 advaced renal tuberculosis cases that had been confirmed by pathologic diagnosis.Result:Irritation symptoms(90.00%),hematuria(66.67%) and lumbodynia (26.67%) were the most cmmon symptoms. Five cases had lost the function of involved kidney although their historis were not over half a year. The positive rate of urinary analysis and ESR were 100.00% and 81.82% respectively. But the positive result of acid fast stains and tubercle bacillus antibody were low. Intravenous urography indicated no image of involved kidney in 16 cases( 57.14%). B-type ultrasonograhpy performed in 30 cases, all cases were abmoral.Conclusion:Atypical symptoms and asymptoms in earlier stage are the main causes of the advanced renal tuberculosis. Correct diagnosis depended on the enough realization of atypical symptoms of renal tuberculosis and the comprehensive analysis of the clinic feature,laboratory test and imaging finding.