肾结核56例临床分析

Clinical Study on Tb Kidney in 56 Cases

目的 提高肾结核的诊疗水平。方法 回顾性分析 56 例肾结核患者的临床资料。结果 尿路刺激征、腰痛、血尿为常见症状。尿沉渣找抗酸杆菌阳性率为 32.0%,静脉尿路造影(intravenous excretory urogram, IVU)、B超、CT的诊断阳性率分别为 60.7%、17.9%、78.1%。药物治疗 22 例,19 例治愈;手术治疗:患肾输尿管切除 35例,肾上极切除1例,输尿管膀胱移植术2例,回肠扩大膀胱术2例。结论 IVU是肾结核诊断的首选方法,CT对中晚期肾结核具有较高的诊断价值。药物治疗对早期肾结核有效,对中晚期肾结核应以手术为主。

Objective To improve the diagnosis and treatment of Tb kidney.Methods Clinical data of 56 cases of Tb kidney were analysed retrospectively.Results Irritability of the urinary tract?lumbar pain and hematuria were known as its frequent symtoms.Positive rate of acid-fast bacilli in urine sedimentation was 32.0%. Positive diagnostic rate of intra-venous excretory urogram(IVU),B ultrasound and CT was 60.7%,17.9% and 78.1% respectively.In 22 cases with drug therapy,19 cured.Surgical treatments included 35 cases of urethrectomy of the affected side,1 case of nephrectomy,2 cases of urethrocystal transplantation,and 2 cases of ileocystostomy.Conclusion IVU should be the first choice in diagnosing Tb kidney.CT has quite high value in diagnosing mid-late stage Tb kidney.Drug medication to early cases is rather effective and to mid-late cases,operative measuqre sould be considered chiefly.