论文部分内容阅读
目的探讨肾周脓肿误诊的主要原因及避免误诊的措施。方法对我院8例肾周脓肿误诊病人作回顾性分析。结果3例误诊为急腹症者行急诊探查,术中证实是肾周脓肿,行肾周冲洗并置管引流,20 d后痊愈。3例误诊为下尿路感染继发肾盂肾炎因抗感染无效及时作肾脏B超、CT等检查获得诊断(为肾囊肿继发脓肿破溃所致)。其中1例穿刺引流后好转;1例切开引流后并发尿瘘,置D-J管内引流40余天好转;另1例行肾切除。1例误诊为胸膜炎及1例误诊为肺炎者因延误诊治太久而死于败血症和多系统器官功能衰竭。结论肾周脓肿误诊最主要的原因是该病症状的非特异性。B超是诊断肾周脓肿的首选方法。为避免误诊,应对急腹症或其他发热病人常规作肾脏B超检查。
Objective To investigate the main causes of misdiagnosis of renal abscess and measures to avoid misdiagnosis. Methods Retrospective analysis of 8 cases of misdiagnosis of renal abscess in our hospital. Results 3 cases were misdiagnosed as acute abdomen emergency exploration, intraoperative confirmed renal peritonitis, perirenal irrigation and catheter drainage, 20 days after healed. 3 cases of misdiagnosed as lower urinary tract infection secondary pyelonephritis due to anti-infective in time for the kidneys B-ultrasound, CT and other tests were diagnosed (due to rupture of renal cysts secondary abscess). One case of puncture and drainage improved; one case of incision and drainage complicated by urinary fistula, D-J tube drainage more than 40 days to improve; the other 1 case of nephrectomy. One patient was misdiagnosed as pleurisy and one patient misdiagnosed as pneumonia died of sepsis and multiple system organ failure due to delayed diagnosis and treatment for too long. Conclusion The most common cause of misdiagnosis of renal abscess is the nonspecific symptoms of the disease. B ultrasound is the preferred method of diagnosis of renal abscess. To avoid misdiagnosis, acute abdomen or other fever patients should be routinely used for renal B-ultrasound.