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泌尿生殖系结核的治疗已有了改变,过去的“必需肾切除”的概念已被“按情况考虑是否肾切除”概念所代替。今天,一般认为结核完全可能用化学疗法治愈。但下列问题必须提出:持续尿培养多久无菌才能被认为是结核已完全治愈?为着观察药物的用量和使用时间来估计化学治疗的效能,可用切除出的结核肾组织作组织切片,做为基础来研究肾结核病变的活动情况。尽管尿培养是持续无菌的,但仍有15％的病人发现有活动性的结核病变。使用利福平,乙胺丁醇和异烟肼三种药物联合应用,治疗2—3个月后有90％的病例结核停止活动。但继续延长治疗期,却未能取得进一步的改善。
The treatment of genitourinary tuberculosis has changed and the concept of “necessary nephrectomy” in the past has been replaced by the notion of “nephrectomized” as the case may be. Today, it is generally accepted that tuberculosis is entirely curable with chemotherapy. However, the following questions must be raised: How long should continuous urine be sterilized before it can be considered completely cured of tuberculosis? In order to observe the amount and duration of drug use to evaluate the efficacy of chemotherapy, resected tuberculous kidney tissue can be used for tissue sections as Basis to study the activity of renal tuberculosis. Although urine culture is consistently sterile, 15% of patients still have active TB lesions. The use of rifampicin, ethambutol and isoniazid three drugs in combination, 90% of cases of tuberculosis after 2-3 months of treatment stopped activity. However, the continuation of the treatment period failed to achieve any further improvement.