CAJ | 학술논문

目的探讨肾结核的早期诊断和治疗.方法回顾分析326例肾结核患者的临床资料.结果尿频、尿急、尿痛、腰痛和血尿是最常见的症状,分别为51.8%、37.2%、33.4%、41.0%和48.1%.IVP、B超、CT、膀胱黏膜活检和MRU诊断符合率分别为69.1%、46.6%、89.8%、44.4%和85.6%.96例抗结核药物(INH+RFP+EMB或PIA)治疗6～8个月,治愈38例(39.4%),好转43例(44.7%).手术治疗245例(75.1%),其中肾切除210例(64.4%),治愈100%,一侧肾切除对侧输尿管再植21例,治愈15例(71.0%),挛缩膀胱行乙状结肠膀胱扩大术9例,治愈8例(88%).5例双肾结核肾积水肾功不全行肾造瘘.结论尿液检查、IVP、膀胱镜检查及黏膜活检对肾结核早期诊断有十分重要的意义.B超、CT、MRU对中晚期肾结核诊断有决定意义.INH+RFP+EMB或PIA三联治疗早期肾结核,效果满意.
목적 탐토신결핵적조기진단화치료.방법 회고분석326례신결핵환자적림상자료.결과 뇨빈、뇨급、뇨통、요통화혈뇨시최상견적증상,분별위51.8%、37.2%、33.4%、41.0%화48.1%.IVP、B초、CT、방광점막활검화MRU진단부합솔분별위69.1%、46.6%、89.8%、44.4%화85.6%.96례항결핵약물(INH+RFP+EMB혹PIA)치료6～8개월,치유38례(39.4%),호전43례(44.7%).수술치료245례(75.1%),기중신절제210례(64.4%),치유100%,일측신절제대측수뇨관재식21례,치유15례(71.0%),련축방광행을상결장방광확대술9례,치유8례(88%).5례쌍신결핵신적수신공불전행신조루.결론 뇨액검사、IVP、방광경검사급점막활검대신결핵조기진단유십분중요적의의.B초、CT、MRU대중만기신결핵진단유결정의의.INH+RFP+EMB혹PIA삼련치료조기신결핵,효과만의.
Objectives To summarize diagnostic and therapeutic experience of renal tuberculosis at early stage. Methods Retrospective analysis on clinical data of 326 cases of renal tuberculosis. Results Frequency, urgency, odynuria,lumbodynia, bematuria were the most common symptoms,and their rates were 51. 8% ,37.2% ,33.4% ,41.0% ,and 48. 1 % respectively. The accuracy of diagnosis in IVP , B- ultrasonography, CT, cystoscopy + mucous membrane biopsy of urinary bladder,and MRU were :69. 1% ,46.6% ,89.8%, 44.4%, and 85.6% respectively. 96 patients underwent antituberculosis drugs( INH + REP + EMB or PIA ) for 6 ～ 8 months. 38 patients( 39.4% ) were cured, while 43 patients(44.7% ) were improved. 245 patients underwent operation, including 210 patients who underwent nephrectomize(64.4% ) ,and cure rate was 100% ;21 patients underwent nephrectomize combined with metanephric duct reimplant, and 15 patients(71.0% ) were cured;9 patients with contractural bladder underwent augmentation of bladder with colon sigmoideum,and 8 patients(88% ) were cured. Conclusions Uronoscopy,IVP, cystoscopy + mucous membrane biopsy of urinary bladder is important in the diagnosis of renal tuberculosis at early stage. B - ultrasonography, CT,and MRU have the crucial value in the diagnosis of advanced renal tuberculosis. Trigminal treatment( INH + REP + EMB or PIA) is satisfactory to the patients with renal tuberculosis at early stage.