87例肾结核的临床分析.doc

新疆医科大学医学硕士学位论文 The Clinical Analysis of 87 Cases of renal Tuberculosis  Postgraduate: Chen Yi Lai  Supervisor: Wang Yu jie Professor  Abstract Objective:In order to improve the level of diagnosis and treatment, the clinical features, diagnosis and therapy of renal tuberculosis were analyzed. Method:eighty seven cases of renal tuberculosis obtained from our hospital in 1997～2007 were retrospectively studied. Those cases were analyzed respectively from clinical data laboratory findings. Results:The incidence of renal tuberculosis were highest among age 31to50 years old. The most frequent symptom of disease was typical cystitis: urinary frequency urgency odynuria. Furthermore hematuria lumbodynia and pyuria also frequent present. The few proportion of patients have other symptoms such as febrile loss of weight, night sweat. The proportion of complicating pulmonary tuberculosis and atypical renal tuberculosis were respectively 9.2%and 56%.The negative results of urine analysis were respectively acid-fast stains on urinary sediment of 10 patients, tubercle bacillus culture of urine of 3 patients and urine PCR- TB-DNA of 1 patient. The diagnose accordance rate of B-type ultrasonography, KUB+IVU and CT were respectively 68%、75%、84%.70 patients underwent nephro-ureterectomy,4 patients underwent Augmentation of bladder and 9 patients underwent biopsy,5 patients underwent cystoureteral anastomosis. 4 patients underwent cystostomy and ensued anti-tuberculosis agents with 6 months. Four patient treated only by anti-tuberculosis agents.76 patients who were followed up were cured. Conclusion:The incidence of renal tuberculosis were highest among age 31 to 50 years old. It was difficult to diagnose the disease in early stage and needed aggregate analysis by clinical manifestation, laboratory test and imaging findinds. So the patients who suspected catch renal tuberculosis should take several tests including urine analysis, acid- fast stains on urinary sediment,uri