摘要
目的:总结肾结核的临床表现特点和诊治策略。方法:回顾性分析兰州大学第二医院在2013年1月1日—2022年12月31日收治的肾结核患者的临床资料。结果:291例肾结核患者高发年龄段为18~45岁。2018—2022年肾结核患者较2013—2017年肾结核患者年龄增大,>60岁人群显著增加(P<0.05)。近5年肾结核患者表现为体重下降者数量增多(P<0.05)。T-SPOT.TB阳性率高达87.70%,PCR荧光探针阳性率80.0%,阳性率较高。单纯抗结核药物的治愈率仅为11.11%,抗结核药物治疗同时配合输尿管支架置入治愈率为38.64%,药物联合手术治疗治愈率为93.88%,单纯手术切除治愈率为55.56%。结论:291例肾结核患者以中青年为主,实验室及影像学检查对肾结核诊断有重要意义,不同治疗方式与患者预后差异比较有统计学意义(P<0.05),抗结核药物联合手术是肾结核的有效治疗方法,单纯药物治疗结果欠佳,手术及辅助治疗仍不可避免。
Objective:To summarize the clinical presentation characteristics and diagnosis and treatment strategies of renal tuberculosis.Methods:The clinical data of patients with renal tuberculosis admitted to Second Hospital of Lanzhou University during the period of January 1st,2013to December 31st,2022were retrospectively analyzed.Results:The high prevalence of 291patients with renal tuberculosis was in the age group of 18-45 years.The age of patients with renal tuberculosis in 2018-2022increased compared with that of patients with renal tuberculosis in 2013-2017,and the number of people>60years old increased significantly(P<0.05).The number of renal tuberculosis patients presenting with weight loss increased in the last five years(P<0.05).The T-SPOT.TB positivity rate was as high as 87.70%and the PCR fluorescent probe positivity rate was 80.0%,which is a high positivity rate.The cure rate of anti-tuberculosis drugs alone was only 11.11%.The cure rate of anti-tuberculosis drug treatment together with ureteral stenting was 38.64%.The cure rate of drug combined with surgical treatment was 93.88%.The cure rate of surgical resection alone was 55.56%.Conclusion:Two hundred and ninety-one cases of renal tuberculosis are mainly young and middle-aged.Laboratory and imaging examinations are important for the diagnosis of renal tuberculosis.The difference between different treatment modalities and patients'prognoses is statistically significant(P<0.05).Anti-tuberculosis drugs combined with surgery is an effective treatment for renal tuberculosis.The results of simple drug treatment are poor,so surgery and adjuvant treatments are still unavoidable.
作者
张雨阳
张婧
后田田
田怡欣
王格
郭宸浩
尚攀峰
ZHANG Yuyang;ZHANG Jing;HOU Tiantian;TIAN Yixin;WANG Ge;GUO Chenhao;SHANG Panfeng(First School of Clinical Medicine,Lanzhou University,Lanzhou,730000,China;Second School of Clinical Medicine,Lanzhou University;Department of Urology,Lanzhou University Second Hospital)
出处
《临床泌尿外科杂志》
2025年第5期413-419,共7页
Journal of Clinical Urology
基金
兰州大学大学生创新创业训练计划项目(No:20230060055,20240060032,20240060189)。
作者简介
通信作者:尚攀峰,E-mail:shangpf@lzu.edu.cn。
