【摘要】 目的提高肾结核的诊断和治疗水平。方法回顾性分析74例肾结核患者的临床资料。结果尿频、尿痛和血尿是最常见的症状,分别为55.6%(41/74例)、43.2%(32/74例)、47.2%(35/74例)。红细胞沉降率增快54例,尿检红细胞阳性率64.9%(48/74),白细胞阳性率54.1%(40/74)、尿蛋白阳性率60.8%(45/74)、脓尿33.8%(25/74);24小时尿沉渣找抗酸杆菌阳性率23.2%。尿PCR找抗酸杆菌DNA阳性73.0%(27/37)。影像学检查B超、IVP、CT、和MRU诊断符合率分别为31.1%、37.7%、73.8%、68.4%。经药物治疗治愈24例,50例行外科干预术后随访1～2年均治愈,其中行一侧肾切除34例,乙状结肠膀胱扩大术2例,肾造瘘5例,置输尿管支架管10例。结论肾结核的诊断主要依靠临床表现、实验室检验和影像学检查。其治疗应根据患者病情和肾脏破坏情况给予个体化治疗。更多还原

【Abstract】 Objective To improve the diagnosis and treatment of renal tuberculosis.Methods The clinical data of 74 cases of renal tuberculosis patients were analysized retrospectively.Results 55.6%(41/74 cases) had urinary frequency,43.2%(32/74 cases) had odynuria and 47.2%(35/74 cases) had hematuria.These three symptoms were more common.73.0%(54/74 cases) had abnormal erythrocyte sedimentation rate.64.9%(48/74) had positive red blood cell number in urine,54.1%(40/74) had positive white blood cell number in urine,60.8%(45/74) had positive urinary protein,33.8%(25/74) pyuria.23.2% were found acid-fast bacilli in 24-hour urine sediment.73.0%(27/37) were positive urine acid-fast bacilli by PCR DNA.The diagnostic coincidence rate of B-ultrasound imaging examination,IVP,CT,and MRU were 31.1%,37.7%,73.8%,68.4% respectively.24 cases were cured by medication,50 cases were carried by routine surgical intervention and had been followed up for 1-2 years,and no case recurred.The surgical intervention included 34 case unilateral nephrectomy,2 case sigmoid bladder augmentation 5 case pelvis-skin fistula and 10 case putting stents in ureter.Conclusion The diagnosis of renal tuberculosis mainly relied on clinical manifestations,laboratory tests and imaging studies.The individualized treatment should be done according to the patient’s condition and kidney damage.更多还原