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目的探讨肾结核诊断与治疗。方法对46例肾结核患者的诊断及治疗进行回顾性研究。结果尿查抗酸杆菌、尿聚合酶链反应结核菌和血清抗结核特异性抗体的准确率分别为15.7%、50%和44%。B超、静脉肾盂造影、逆行性肾盂造影和CT准确率分别为24.2%、57.9%、66.7%和80.6%。单纯抗结核药物治愈11例。患肾切除32例,患肾造瘘、肾盂输尿管离断成型1例,输尿管膀胱再植入1例。扩大膀胱术1例。结论B超、静脉肾盂造影对肾结核的诊断缺乏特异性。聚合酶链反应结核菌、CT在肾结核诊断中起着越来越重要的作用。肾结核治疗仍以肾切除术为主要方法,同时应尽可能切除患侧输尿管。
Objective To investigate the diagnosis and treatment of renal tuberculosis. Methods The diagnosis and treatment of 46 patients with renal tuberculosis were retrospectively studied. Results The accuracy of urinalysis of acid-fast bacilli, urine polymerase chain reaction (TB) and anti-TB specific antibodies were 15.7%, 50% and 44% respectively. B ultrasound, intravenous pyelography, retrograde pyelography and CT accuracy were 24.2%, 57.9%, 66.7% and 80.6%. Simple anti-tuberculosis drugs to cure 11 cases. Nephrectomy in 32 cases, suffering from nephrostomy, ureteropelvic disconnection in 1 case, ureteral bladder replantation in 1 case. Expand bladder surgery in 1 case. Conclusion B ultrasound, intravenous pyelography on the diagnosis of renal tuberculosis lack of specificity. Polymerase chain reaction Mycobacterium tuberculosis, CT in the diagnosis of renal tuberculosis plays an increasingly important role. Renal tuberculosis treatment is still the main method of nephrectomy, resection of the ureter should be as much as possible.