中晚期肾结核的临床特征及影像学分析.pdfVIP

摘 要 中晚期肾结核的临床特征及影像学分析 研究生：贾宏亮 导师：闵立贵教授 摘 要 目的：探讨中晚期肾结核的临床特点及影像学诊断方法。方法：分析经手术病 理证实的中晚期肾结核101例的临床表现，并比较B超、静脉肾盂造影(IVP) 、CT对 中晚期肾结核的诊断价值。101例患者中，其中86例行B超检查、69例行IVP检查 、 62例行CT 检查。将均行上述三项检查的37例患者的影像学表现与其病理结果进行对 照研究，将三种影像学方法显示肾脏不规则钙化、肾实质空洞这两种典型肾结核改 变结果进行统计学分析。结果：临床表现中，腰痛、膀胱刺激征、血尿是最常见的 临床症状。B超、IVP 、CT的诊断准确率分别为31.4%、43.5%和90.3% 。三种检查方 2 法相比，差异有统计学意义（? =53.122 ，P=0.000 ）；与B超及IVP 比较，CT诊断肾 2 2 结核有明显优势，差异有统计学意义（? ＝50.792 ，P=0.000 ；? ＝31.777，P=0.000 ）。 2 CT对肾结核钙化、肾实质空洞的显示明显优于B超和IVP(? = 15.868，P=0.000 ； 2 ? =45.30 1，P=0.000) 。结论：肾结核的临床表现多不典型，CT 对中晚期肾结核的诊 断有重要价值，可作为中晚期肾结核的首选检查方法。 关键词：肾结核；临床特征；影像学 —1— 新疆医科大学医学硕士学位论文 Clinical characteristic and imaging analysis for advanced renal tuberculosis Postgraduate:JIA Hongliang Supervisor: Prof.MIN Ligui Abstract Objective: To explore clinical characteristic and the diagnostic technique of imaging for advanced renal tuberculosis.Methods: Retrospectively analyze the clinical syndromes and compare the B-ultrasonography,IVP,and CT findings of 101 patients with the advanced renal tuberculosis which had been confirmed by operations.86 patients underwent B-ultrasonography examination;69 patients took IVP examination;62 patients had CT exmanation. According to pathological characteristics of renal tuberculosis ，we compared the typical imagin feature including calcification and renal parenchyma cavity in 37 patients who underwent three exmainations above.Results: Lumbodyn