非典型性肾结核8例

Experiences of diagnosis and management in atypical renal tuberculosis (Report of 8 cases)

目的 :提高对不典型肾结核的诊断和治疗水平。方法 :回顾性分析 8例误诊的非典型肾结核临床资料。结果 :行肾切除术 2例 ,右肾切除和肠膀胱扩大术 1例 ,右肾输尿管全切术 3例 ,肾造瘘和活检 1例 ,抗结核治疗 1例。结论 :非典型肾结核的特殊性在于缺乏肾结核的典型临床表现 ,而主要表现为大量血尿、肾区及腹部疼痛、发热、前列腺炎或泌尿系外结核病灶等症状 ;缺乏实验室检查。

Purpose: To improve the diagnosis and management of atypical renal tuberculosis. Methods: 8 cases of misdiagnosed atypical renal tuberculosis were reviewed retrospectively. Results: Surgical removal of the affected organs were performed in 7 cases, including nephrectomy in 2, nephrectomy and ileocystoplasty in 1, nephroureterectomy in 3, nephrostomy and biopsy in 1, Strict medical tretment with antituberculosis drugs in 1 cases. Conclusions: The peculiarities of atypital renal tuberculosis were as followings:Lack of classic clinical pictures, but with gross hematuria,renal and abdominal pain, fever,prostatitis like or extra-urinary tract tuberculosis originated symptoms; lack of typical laboratory, cystoscopic and X ray findings. The optimal diagnostic approach and the management for patients with documented upper tract obstruction,low grade of renal involvement and reasonable renal function was emphasized.