60例肾结核临床诊治分析

Diagnosis and Treatment of Renal Tuberculosis: An Analysis of 60 Cases

目的探讨肾结核的早期诊断和治疗,提高肾结核的诊治水平。方法对60例肾结核患者的临床资料进行回顾性分析。结果单纯抗结核药物治疗的15例患者随访2～8年,14例治愈,1例失访;手术治疗的43例患者41例获得2～6年的随访,其中3例出现患肾萎缩,38例患肾体积增大并有不同程度的肾积脓,术后病理检查均确诊为肾结核;2例失访。1例双肾结核并结核性小膀胱患者抗结核治疗1.8年,随访至今,膀胱刺激症状明显改善;1例双肾结核并尿毒症行血液透析患者失访。结论肾结核早期诊断困难,需要综合分析;无功能结核肾切除仍是中晚期肾结核的主要治疗手段。

Objective To investigate and improve the diagnosis and treatment of renal tuberculosis.Methods Clinical data of 60 patients with renal tuberculosis were retrospectively analyzed.Results Among the 15 patients who were treated with anti-tuberculosis drugs and followed up for 2-8 years,14 were cured and 1 was loss to follow-up.Among the 43 patients who underwent surgical treatment,41 were followed up for 2-6 years（3 patients with renal atrophy and 38 patients with increased kidney volume and various degrees of pyonephrosis）and pathologically diagnosed as having renal tuberculosis,and 2 were loss to follow-up.One patient with bilateral renal tuberculosis and small tuberculous bladder received anti-tuberculosis treatment for 1.8 years,and has so far achieved significant improvement in the bladder irritation symptoms.One patient with renal tuberculosis and uremia who underwent hemodialysis was loss to follow-up.Conclusion Early diagnosis of renal tuberculosis is difficult and need comprehensive analysis.Non-functioning tuberculosis kidney resection is still the main treatment for advanced renal tuberculosis.