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目的:探讨中晚期肾结核的诊断和治疗。方法:回顾性分析手术治疗的245例中晚期肾结核患者的临床资料:尿频、尿急、尿痛、腰痛和血尿是最常见的症状,分别为55.5%、41.2%、29%、31.8%和53.8%;IVP、B超、CT、、膀胱黏膜活检和MRU诊断符合率分别为30.2%,57.1%,89.8%,29.1%和85.6%。手术治疗245例,其中肾切除210例,一侧肾切除对侧输尿管再植21例,挛缩膀胱行乙状结肠膀胱扩大术9例,双肾结核肾积水肾功不全5例行肾造瘘。结果:245例患者中,治愈238例,未愈7例,治愈率97.1%。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。中晚期肾结核需手术治疗。
Objective: To investigate the diagnosis and treatment of advanced renal tuberculosis. Methods: The clinical data of 245 patients with advanced renal tuberculosis treated by surgery were retrospectively analyzed. Frequent urination, urgency, dysuria, back pain and hematuria were the most common symptoms, which were 55.5%, 41.2%, 29%, 31.8% and 53.8%. The coincidence rates of IVP, B-ultrasound, CT, urinary bladder biopsy and MRU were 30.2%, 57.1%, 89.8%, 29.1% and 85.6% respectively. Surgical treatment of 245 cases, of which 210 cases of nephrectomy, contralateral ureter on one side of the renal resection in 21 cases, contracting bladder sigmoid colon expansion in 9 cases, renal tuberculosis renal hydronephrosis 5 cases of renal fistula. Results: In 245 patients, 238 cases were cured, 7 cases were cured, the cure rate was 97.1%. Conclusion: Urinalysis, IVP, cystoscopy and mucosal biopsy are very important for the early diagnosis of renal tuberculosis. B ultrasound, CT, MRU diagnosis of advanced renal tuberculosis has a decisive significance. Nephrotic tuberculosis in the need for surgical treatment.