肾结核合并肾结石11例诊治分析

Diagnosis and treatment of 11 cases of renal tuberculosis combined with renal calculus

目的：探讨肾结核合并肾结石的诊断及治疗方法。方法对11例肾结核合并肾结石患者进行治疗，其中8例行肾切除术，2例行经皮肾镜碎石术（ PCNL），1例患者行体外冲击波碎石术（ ESWL）。结果术后病理学检查均提示肾结核伴干酪样坏死，所有患者术后给予抗结核药物治疗6∽12个月，定期复查血常规、肝肾功能、B超、尿结核DNA及CT等，恢复良好。结论对明确诊断的肾结核合并肾结石患者，需严格行抗结核治疗，采取合适的手术方式处理结石。

Objective To discuss the diagnosis and treatment of renal tuberculosis combined with renal calculus. Methods Among the 11 cases of renal tuberculosis combined with renal calculus,8 cases underwent nephrectomy,2 cases underwent percutaneous nephrolithotomy lithotripsy（ PCNL）,and 1 case underwent extracorporeal shock wave lithotripsy（ ESWL）. Results The pathological diagnosis indi-cated renal tuberculosis and caseous necrosis. Anti-TB drugs were given for 6 to 12 months,and blood a-nalysis,liver and kidney function,B-mode ultrasonography,urinary tuberculosis DAN testing,CT and other tests were regularly reviewed. There was good recovery. Conclusion Early symptoms of renal tuberculosis are non-specific,and the late symptoms are often overshadowed by complicated renal calculus perform-ance. After the diagnosis is clear,the renal function is usually lost,which ultimately leads to nephrectomy. Therefore in clinical diagnosis and treament,we should enhance the understanding of renal tuberculosis disease and reduce the rate of misdiagnosis of renal tuberculosis. Patients with a clear diagnosis of renal tuberculosis with renal calculus requires strict anti-TB treatment and appropriate surgical approach to cal-culus.