摘要
目的:探讨肾结核诊断与治疗。方法:对92例肾结核患者的诊断及治疗进行回顾性分析。结果:尿沉渣涂片找抗酸杆菌、尿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)的阳性率分别为15.8%、53.8%和45.1%。B超、IVU、CT和磁共振尿路成像(MRU)阳性率分别为18.8%、48.9%、79.1%和81.0%。单纯抗结核药物治愈22例,开放肾切除术45例,后腹腔镜肾切除术25例。术中失血量、术后住院日及术后卧床时间比较,后腹腔镜组明显少于开放手术组。结论:对不典型肾结核的早期诊断需提高认识,重视病史。聚合酶链反应结核菌、CT和MRU在肾结核诊断中起着越来越重要的作用。早期肾结核患者行三联化疗有效。晚期肾结核行肾输尿管切除术十分重要,后腹腔镜肾切除术是无功能结核肾理想的外科治疗方法。
Objective：To investigate the diagnosis and treatment of renal tuberculosis（TB）. Methods：A retrospective study was performed on 92 cases of renal TB. Results：The positive result of acid fast stains,urinary TBPCR, PPD-IgG were 15.8%、 53.8% and 45.1% respectively. The diagnostic accuracy of urography, MRU, CT and B type uhrasonography were 48.9%. 81.0%, 79.1% and 18.8%. 22 early cases have been cured on medicine （ INH＋RFP＋PZA for 6 12 months ）. 70 cases received Nephroureterectomy including 25 retroperitoneal laparoscopic nephrectomy. The mean blood loss, hospital stay and in-bed time of laparoscopic group were significantly improved than the open operation group. Conclusions： PCR-TB-DNA, CT and MRU play important roles in diagnosis of renal TB. Chemical therapy yield satisfactory outcome for early cases. Retroperitoneal laparoscopie nephrectomy is a minimally invasive, safe and effective therapy for nonfunctional tuberculosis kidneys.
出处
《临床泌尿外科杂志》
2008年第8期587-588,591,共3页
Journal of Clinical Urology
关键词
肾结核
诊断
腹腔镜肾切除术
Tuberculosis renal
Diagnosis
I.aparoscopic nephrectomy
