在肾结核治疗中早期输尿管支架管内引流的作用

Role of early internal ureteral stent drainage treatment for renal tuberculosis

目的探讨在药物治疗肾结核中早期输尿管内引流的疗效。方法总结2003年6月～2010年10月22例肾结核患者,在应用抗结核药物的同时经膀胱镜或切开输尿管内放置双猪尾式(DJ)导管内引流,DJ管保留6～9个月,每3个月复查并更换DJ管1次,抗结核药物应用9～12个月。结果 22例患者中19例结核病灶稳定或消失,尿常规正常,强化CT扫描显示肾功能正常或接近正常。3例在6～8个月后结核肾病变严重,功能丧失,行患肾切除。结论对肾结核在应用抗结核药物治疗的同时留置输尿管内引流,可防止输尿管狭窄,加快病灶的愈合及保留患侧肾脏结构和功能,降低肾脏切除率,取得临床上较为理想的效果。

[Objective] To investigate the role of early internal ureteral stent drainage in the renal tuberculosis.[Methods] From Jun 2003 to December 2010,22 cases of the renal tuberculosis were treated using antitubercular agents combining with internal ureteral stent.The stent was to place trans-cystoscopes or intervention surgery.All 22 patients were followed up for each 3 months and were changed double-J catheter.The double-J catheter was reservation for 6 to 9 months.Antitubercular agents were given 9 to 12 months.[Results] Nineteen of the 22 cases renal tuberculosis lesion were obviously reduced and disappeared in six to nine months.Urinary was normal by microscopic examination,kidney function was normal in the enhancement CT scanning.Three cases were treated nephrectomy after 6 months because of the renal tuberculosis lesion severity and the renal function was losses of kidney enhancement CT scanning.[Conclusion] Renal tuberculosis were treated by internal ureteral stent drainage,to prevent ureteral stricture of internal ureteral stent,it is to promote healing of the lesions and can better preserve the structure and function of the kidney,and can help lower the rate of nephrectomy,and achieve clinical satisfactory effect.