CAJ | 학술논문

目的：探讨不典型泌尿系统结核患者的临床诊治体验。方法选取安阳市结核病防治所2011年4月至2013年2月收治的40例不典型泌尿系统结核患者为研究对象，将其归入研究组（ A组），将同一时间入院体检的40例健康志愿者也纳入研究范围并归入对照组（ B组）。均对两组患者予以静脉肾盂造影（ IVP）、B超、X线平片、CT等检测方案，对比其临床诊断敏感性与特异性差异。根据患者临床指征及治疗适应证等差异选择不同治疗方案，记录其临床疗效。结果①CT和IVP检查的敏感性与特异性分别为97．5％、97．5％和95．0％、97．5％，差异未见统计学意义（ P＞0．05）；其次为B超，该检测方案敏感性与特异性分别为87．5％和82．5％，X线检测准确度最低，差异有统计学意义（ P＜0．05）；②两种治疗方案均获得理想疗效，总有效率均超过90．0％，差异未见统计学意义（P＞0．05）。结论对不典型泌尿系统结核患者予以IVP、CT、X线等联合诊断方案，可有效提高其临床诊断准确性，规避误诊或漏诊风险；患者需根据其具体病情、发展阶段及自身耐受性差异等选择最佳治疗方案。
목적：탐토불전형비뇨계통결핵환자적림상진치체험。방법선취안양시결핵병방치소2011년4월지2013년2월수치적40례불전형비뇨계통결핵환자위연구대상，장기귀입연구조（ A조），장동일시간입원체검적40례건강지원자야납입연구범위병귀입대조조（ B조）。균대량조환자여이정맥신우조영（ IVP）、B초、X선평편、CT등검측방안，대비기림상진단민감성여특이성차이。근거환자림상지정급치료괄응증등차이선택불동치료방안，기록기림상료효。결과①CT화IVP검사적민감성여특이성분별위97．5％、97．5％화95．0％、97．5％，차이미견통계학의의（ P＞0．05）；기차위B초，해검측방안민감성여특이성분별위87．5％화82．5％，X선검측준학도최저，차이유통계학의의（ P＜0．05）；②량충치료방안균획득이상료효，총유효솔균초과90．0％，차이미견통계학의의（P＞0．05）。결론대불전형비뇨계통결핵환자여이IVP、CT、X선등연합진단방안，가유효제고기림상진단준학성，규피오진혹루진풍험；환자수근거기구체병정、발전계단급자신내수성차이등선택최가치료방안。
Objective To investigate the clinical diagnosis and treatment of atypical tuberculosis of urinary system.Methods From April 2011 to February 2013 , 40 cases of atypical tuberculosis of uri-nary system who were treated in our hospital were selected as research group(group A), and other 40 healthy volunteers were treated as control group( group B) .Patients of two groups were treated with intra-venous pyelography( IVP) , type-B ultrasonic, X-ray film and CT, the clinical diagnostic sensitivity and specificity differences were compared.Then made a different treatment options based on clinical indica-tionsandtreatmenttherapeuticindications,andtheclinicalefficacywasrecorded.Results ①Thesen-sitivity and specificity of CT and IVP was 97.5%, 97.5%and 95.0%, 97.5%, there was no significant difference(P>0.05).Then the sensitivity and specificity of type-B ultrasonic was 87.5%and 82.5%, X-ray detection accuracy was the lowest, the difference were significant( P<0.05) .②both therapeutic schedules had ideal effect, the total effective rates were all over 90.0%, there was no significant differ-ence(P>0.05).Conclusions Treat patient with atypical tuberculosis of urinary system with IVP, CT and X-ray can improve the accuracy of diagnosis, avoid the risk of erroneous diagnosis and misdiagnosis, and the patients can be treated with the best option according to their specific conditions, stage of devel-opment and self-tolerance differences.