肾结核的诊断要点分析

Diagnostic keypoint analysis of renal tuberculosis

目的:分析和总结肾结核的临床特点,提高早期诊断水平。方法:收集近5年我院收治的69例存档病例资料,系统采集病史资料及各项辅助检查数据。结果:本研究包括28例男性,41例女性。最常见症状依次为膀胱刺激征46例(66.7),腰腹痛30例(43.5),肉眼血尿29例(42.0)。尿常规异常58例(85.5);尿抗酸杆菌检查27例,阳性3例(11.1)。超声、静脉肾盂造影、逆行肾盂造影、CT、MRI、膀胱镜检+活检的诊断率分别为63.2(43/68)、46.9(15/32)、85.7(12/14)、64.3(9/14)、90.9(10/11)、10(1/10)。结论:当就诊患者长期有不能解释的泌尿系症状时,应考虑结核性疾病可能。综合分析病史,联合应用各种实验室和影像学检查结果,是早期诊断的必要条件。

Objective：To discuss the characteristic and improve the early diagnosis ability of renal tuberculosis. Methods：Sixty nine consecutive patients with discharge diagnosis of renal tuberculosis in our hospital were studied. Systematically collect clinical data including case history, symptoms and results of auxiliary examinations. Results： There are 28 males and 41 females. The commonest presenting symptoms were frequency, urgency, and odynuria （66.7 % ）, flank or back pain （43.5 % ）, macroscopic haematuria （42.0 % ）. Microscopic haematuria and/or pyuria were detected in 85.5 % of the patients. Only 11.1% of the patients had positive smears of Mycobacterium tuberculosis. The diagnosis rates of ultrasonography, excretory urography, retrograde pyelography, CT, MRI, cystoscopy with biopsy were 63.2%（43/68） ,46.9%（15/32） ,85.7%（12/14） ,64.3%（9/14）,90.9%（10/11）,10%（1/ 10）respectively. Conclusions： It is advised that patients with unexplained symptoms in the urinary tract should he investigated for tuberculosis. It is necessary to combine patients＇ history, symptoms and auxiliary examinations for early diagnosis of renal tuberculosis.