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目的 探讨临床肾结核的早期诊断和治疗。 方法 回顾性分析 2 81例肾结核患者的临床资料。 结果 膀胱刺激征、血尿和腰痛是最常见的临床症状。尿查抗酸杆菌、聚合酶链反应结核菌 (PCR TB DNA)和血清抗结核特异性抗体 (PPD IgG)检查阳性率分别为 42 .7%、44 .1%和6 2 .5 % ;IVU、B超、CT的诊断阳性率分别为 6 9.1%、2 8.3%、84.3%。 12 8例药物 (异烟肼 +利福平+吡嗪酰胺三联治疗 ,6～ 8个月 )治疗者中 10 5例获痊愈 ,15 3例手术治疗者中 145例 (94.8% )施行患侧肾输尿管联合切除术。 结论 联合实验室检查可使临床不典型肾结核的诊断阳性率得到较大提高。IVU仍然是肾结核诊断的首选影像学检查 ,CT对可疑病例有一定的辅助诊断价值。早期肾结核短程三联治疗效果满意。肾结核肾切除应尽可能切除患侧输尿管。
Objective To investigate the early diagnosis and treatment of clinical renal tuberculosis. Methods The clinical data of 2 81 cases of renal tuberculosis patients were retrospectively analyzed. Bladder irritation, hematuria and back pain were the most common clinical symptoms. The positive rates of urine acid-fast bacilli, PCR TB DNA and serum anti-tuberculosis specific antibody (PPD IgG) were 42.7%, 44.1% and 62.5%, respectively. IVU , B ultrasound, CT diagnostic positive rates were 6 9.1%, 2 8.3%, 84.3%. One hundred and twenty-five patients (126%) were cured with 125 cases of drug (isoniazid + rifampicin + pyrazinamide triple therapy, 6-8 months), and 145 (94.8%) of the 15 3 cases were treated Renal ureter combined resection. Conclusions Combined laboratory tests can greatly improve the diagnostic positive rate of atypical renal tuberculosis. IVU is still the first imaging diagnosis of renal tuberculosis diagnosis, CT suspected cases have some auxiliary diagnostic value. Short-term early treatment of renal tuberculosis triple satisfactory results. Renal tuberculosis should be removed resection of the ipsilateral ureter.