摘要
目的:探讨中晚期肾结核的临床特征,分析延迟诊断原因,提高肾结核早期诊断率。方法:回顾性分析中晚期肾结核患者102例的临床资料,均无典型临床表现。尿抗酸杆菌阳性率为20.5%(16/52);B超(晚期)、IVU、和CT(早期)诊断有异常改变者分别占74.5%(76/102)、84.3%(75/89)、80.9%(72/89)。结果:单纯药物治疗36例,药物结合手术治疗66例。随访6～18月,99例痊愈,3例失访。结论:肾结核的早期诊断比较困难,尿常规、B超、静脉肾盂造影为主要诊断方法,诊断性治疗是早期确诊的重要依据。单纯药物治疗治愈率低,中晚期多需手术治疗。
Objective:To discuss the clinical characteristics and the cause of delaying diagnosis of renal tuberculosis. Methods:Retrospective analysis of the clinical data of 102 cases with renal tuberculosis was made. Positive rate of acid-fast stains on urinary sediment was 20.5% (16/52). The diagnostic accuracy of B-ultrasonogram,IVU and CT in these patients was 74.5%(76/102)、84.3 %(75/89) and 80.9%(72/89) respectively. Results:36 cases had received antituberculotic treatment,while 66 cases had undergone operation plus medicines.Totally 99 cases healed and 3 cases failed to be followed up during 6-18months. Conclusion:The misdiagnosis rate of early renal TB is still high. The diagnostic methods are urinary routine,B-ultrasound,IVU. And diagnostic treatment are important basis for confirmed diagnosis.The healing rate of pharmacotherapy alone was low. The advanced renal tuberculosis was still treated with nephrectomy.
关键词
肾结核
早期诊断
诊断性治疗
Renal tuberculosis
Early diagnosis
Diagnostic treatment
