CAJ | 학술논문

目的探讨临床肾结核的诊断、治疗及误诊原因.方法回顾性分析本院2009～2013年22例肾结核患者的临床资料,男10例,女12例,发病年龄19 ～77岁,中位年龄52.6岁;病程2周～40年;22例患者中症状不典型者(非典型肾结核)12例.结果初诊误诊者占63.6％(14/22);尿找抗酸杆菌、尿聚合酶联反应结核菌检查(PCR-TB-DNA)阳性率分别为68.8％、58.3％;B超、IVP、CT诊断的阳性率分别为18.2％、37.5％、83.3％;8例行保守治疗,14例行肾切除术.结论近年来肾结核的发病率有所升高,不典型肾结核病例增多尤为突出,临床误诊率较高,IVP联合实验室检查对肾结核的早期诊断、降低不典型肾结核的误诊率有重要意义,B超、CT及MRU对中晚期肾结核具有重要意义.
목적 탐토림상신결핵적진단、치료급오진원인.방법 회고성분석본원2009～2013년22례신결핵환자적림상자료,남10례,녀12례,발병년령19 ～77세,중위년령52.6세;병정2주～40년;22례환자중증상불전형자(비전형신결핵)12례.결과 초진오진자점63.6％(14/22);뇨조항산간균、뇨취합매련반응결핵균검사(PCR-TB-DNA)양성솔분별위68.8％、58.3％;B초、IVP、CT진단적양성솔분별위18.2％、37.5％、83.3％;8례행보수치료,14례행신절제술.결론 근년래신결핵적발병솔유소승고,불전형신결핵병례증다우위돌출,림상오진솔교고,IVP연합실험실검사대신결핵적조기진단、강저불전형신결핵적오진솔유중요의의,B초、CT급MRU대중만기신결핵구유중요의의.
Objectives To Study the diagnosis,treatment and misdiagnose reasons of renal tuberculosis (TB).Methods Retrospective analysis of the clininal materials of 22 cases of renal tuberculosis of our hospital from 2009 to 2013.The patients consisted of 10 males and 12 females with age ranging from 19-77 years,The d-uration of the disease ranged from 2 weeks to 40 years.Among the 22 cases,atypital renal tuberculosis was 12.Results The preliminary misdiagnosis rate was 63.6％ (14/22),The positive rate of acid-fast stains and urinary TB-PCR was 68.8％ and 58.3％ respectively;The positive rate of B ultrasound,IVP,CT diagnosis were 1 8.2％,37.5％,83.3％,8 patients received conservative treatment,14 patients underwent nephrectomy.Conclusions The incidence of renal tuberculosis rate has increased in recent years,increasing of atypical renal tuberculosis is particularly prominent,the misdiagnosis rate is high,IVP combined laboratory examination on early diagnosis of renal tuberculosis,reducing the rate of misdiagnosis of atypical renal tuberculosis is very important,B ultrasound,CT and MRU have the decisive significance to the diagnosis of advanced renal tuberculosis.