67例不型肾结核临床及影像学分析.docVIP

67例不典型肾结核临床及影像学分析 　　【摘要】 目的 探讨不典型肾结核的临床及影像学特征。方法 回顾性分析67例不典型肾结核患者的临床及影像学资料。结果 67例不典型肾结核患者行静脉尿路造影检查， 发现阳性改变64例（95.5%）。67例患者行B超检查， 发现阳性改变59例（88.1%）， 其中明确诊断者15例（22.4%）。67例患者行CT检查47例， CT诊断准确42例（89.4%）。尿常规异常者57例， 连续3 d留尿找结核杆菌者60例， 其中阳性者23例（38.3%）， 血沉加快者28例（41.8%）。67例患者经药物治疗的患者13例， 经手术治疗的患者54例， 治疗效果均满意。结论 影像学检查对诊断肾结核具有非常重要的意义， 螺旋CT检查对肾结核的诊断具有越来越重要的临床价值。对早期不典型肾结核完全可通过药物治愈， 但对中、晚期不典型肾结核， 肾切除术仍是主要治疗手段。 中国论文网 /6/viewhtm　　【关键词】 肾结核；临床；影像学 　　DOI：10.14163/j.cnki.11-5547/r.2015.31.002 　　Clinical and imaging analysis of 67 atypical renal tuberculosis cases WEI Xu， ZHAO Zhi-qing， YIN Yong-hua， et al. Department of Urology Surgery， Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University， Guangzhou 518104， China 　　【Abstract】 Objective To investigate clinical and imaging characteristics of atypical renal tuberculosis. Methods A retrospective analysis was made on clinical and imaging data of 67 atypical renal tuberculosis patients. Results Those 67 cases with atypical renal tuberculosis received intravenous urography examination， which showed 64 cases with positive changes （95.5%）. They received B ultrasound examination， and there were 59 cases with positive changes （88.1%）， along with 15 clearly diagnosed cases （22.4%）. 47 cases among 67 cases received CT examination， and there were 42 cases with accurate diagnosis （89.4%）. There were 57 cases with abnormal urine routine and 60 cases with mycobacterium tuberculosis detection in urine for continuous 3 d. Among them， 23 cases were positive （38.3%） and 28 cases had quickened erythrocyte sedimentation rate （41.8%）. There were 13 cases receiving drug therapy and 54 cases receiving surgical treatment in the 67 cases. They all got satisfactory effects. Conclusion Imaging examination contains highly important significance for diagnosis of renal tuberculosis， and spiral CT provides increasingly important clinical value. Early atypical renal tuberculosis can be cured completely by drug medication measures， while moderate