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目的 :探讨黄色肉芽肿性肾盂肾炎 (XGP)的诊治方法。方法 :分析了 8例XGP的临床资料 ,并就其临床表现、诊断及治疗进行分析讨论。结果 :7例术前误诊或漏诊 ,1例术前诊为XGP ;7例呈弥漫型XGP患者行患肾全切 ,1例呈局限型XGP行肿块剜除术 ,术后疗效好 ,未见复发。结论 :对于有长期尿路感染史以及X线发现某些可疑性改变者 ,CT、DSA以及B超有助于正确诊断。尿沉淀找泡沫细胞和B超引导下细针穿刺活检可以明确诊断。治疗上对弥漫型病变主张肾全切除术 ,局限型主张行肾部分切除或肿块剜除术。
Objective: To investigate the diagnosis and treatment of yellow granulomatous pyelonephritis (XGP). Methods: The clinical data of 8 cases of XGP were analyzed and their clinical manifestations, diagnosis and treatment were analyzed and discussed. Results: Seven cases were misdiagnosed or missed before operation. One case was preoperatively diagnosed as XGP. Seven patients with diffuse XGP were treated with total nephrectomy and one case with limited XGP. The curative effect was good after operation relapse. CONCLUSION: CT, DSA and B-ultrasound are helpful in the correct diagnosis of patients with long-term urinary tract infections and some suspicious findings of X-ray findings. Urine sedimentation to find foam cells and B-guided fine needle aspiration biopsy can confirm the diagnosis. Treatment of diffuse lesions advocated total nephrectomy, limited type advocated partial nephrectomy or lump removal surgery.