20例肾结核临床诊治分析

Analysis on the Diagnosis and Treatment of 20 Cases with Renal Tuberculosis in Plateau Area

目的探讨肾结核的临床特征及有效治疗方法。方法对20例肾结核患者的临床资料进行回顾性分析。结果18例尿常规异常（90％），10例血沉异常（50％），尿液查找抗酸杆菌12例呈阳性（60％），B超提示肾脏结核12例（60％），CT检查10例诊断肾结核（50％），IVP检查诊断肾结核14例（70）。14例患者手术后经病理确诊为肾结核，随访1-2年治疗效果稳定，未发现尿路结核。结论肾结核的临床表现不典型，其诊断应在结合临床表现的前提下以实验室检查与影像学诊断为主。治疗仍以手术切除肾脏为主，应尽可能切除患侧全程输尿管。

Objective To discuss the clinical features and effective treatment of renal tuberculosis. Methods A retrospective a nalysis was made to clinica data of 20 cases with renal tuberculosis. Results There were 18 cases with abnormal urine routinew （90%）, 10 cases with abnormal ESR （50%）, acid -fast bacilli from the urine of 12 cases were positive （60%）, ultrasonic examination indicated 12 cases with renal tuberculosis （60% ） , 10 cases were diagnozed to have renal tuberculosis by CT Scanning （50%） and 14 cases by IVP （70%） ; 14 operated cases were pathologically confirmed to have renal tuberculosis, and followup for 1 to 2 years showed stable curative effect and no occurrence of urinary tuberculosis. Conclusions Renal tuberculosis is of atypical clinical manifestations, the diagnosis should depend on the lab tests and imaging diagnosis combined with the clinical symptoms; the primary treatment is nephrectomy with total ureter excision.