摘要
目的总结泌尿系结核各种诊断方法的特征,提高泌尿系结核的诊断水平。方法选择近2年来多个科室反馈诊断72例泌尿系结核,总结泌尿系结核的病理特征和影像学特征,比较各种病原学检查方法。结果患者最常见的主诉为尿路刺激征和血尿,分别为87.5%和47.2%;尿沉渣涂片找抗酸杆菌、尿TB培养和尿PCR-TBDNA阳性率分别为21.7%、27.3%和58.7%;IVP、超声、MRU、膀胱镜检查和CT的准确率分别为35.5%、48.6%、66.7%、88.9%和90.1%。结论泌尿系结核的临床诊断应综合病史、尿液分析、影像学检查、病原学诊断等多种方法。超声、尿常规为筛选,尿PCR-TBDNA对诊断有重要的参考意义,CT诊断价值最大;膀胱镜检查直观、准确,诊断意义显著。相互反馈信息可帮助提高影像学诊断水平。
[Objective] To evaluate the characters of methods for the improvement of the diagnostic accuracy of the urinary tubercolusis. [Methods] By exchanging diagnostic experience on 72 eases of urinary tuberculosis among the related departments in recent 2 years, we summarized the characters of the image and pathology, and compared the etiological methods. [Results] Irritative symptoms 87.5% and gross hematurla 47.2% were the most common symptoms seen in these patients. The positive rate of the acid-fast stains on urinary sediment, urine acid-fast baeillculture and PCR TBDNA in urine were 21.7%, 27.3% and 58.7% respectively. The diagnostic accuracy of IVP, sonography, MRU, cystoscopy and CT were 35.5%, 48.6%, 66.7%, 88.9% and 90.1% respectively. [Conclusions] The patient history, urine analysis, the image evaluation and pathogen detection should be combined in the clinical diagnosis. Patients with renal tuberculosis can be screened by sonography and urine routine test, PCR-TBDNA in urine can provide important reference for the diagnosis, CT has great value for diagnosing renal tuberculosis; cystoscopy is visual and accurate, has significant meaning in the diagnosis. The diagnostic experience can help the doctor to raise the diagnostic level of the image.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2006年第19期2957-2959,2962,共4页
China Journal of Modern Medicine
关键词
肾结核
诊断
影像学
超声检查
kidney tuberculosis
diagnosis
imaging
ultrasonography
