泌尿、男生殖系結(jié)核-wenkub.com
2025-05-23 12:13 本頁面
【正文】 ? 鑒別診斷： ? 前列腺炎 —普 通抗菌素有效 ? 前列腺癌 —老 年， DRE, PSA ? 治療： ? 采用藥物治療為主，一般不采用手術(shù)治療。 2. 如治療效果不明顯或病變較大 ， 有膿腫形成 ， 則可行附睪切除 ， 術(shù)時應盡量保留睪丸 。 ? 附睪逐漸增大，多無明顯疼痛，腫大的附睪可與陰囊粘連或形成寒性膿腫、破潰成為竇道，經(jīng)久不愈。 2. 若積水嚴重，腎功能不良則應先解除 梗阻，然后切除無功能的結(jié)核腎臟。 ? 機體低抗力低時：以破壞為主 —潰 瘍和膿腫 ? 機體低抗力高時：以修復反應為主 —纖 維化和鈣化 Pathology 病理型腎結(jié)核 臨床型腎結(jié)核 腎積膿 輸尿管結(jié)核 腎自截 膀胱結(jié)核 前列腺結(jié)核 附睪結(jié)核 Clinical findings ? Tuberculosis of the genitourinary tract should be considered in the presence of any of the following situations: 1. Chronic systitis that refuses to respond to therapy. 2. The finding of without bacteria in culture of the urinary sediment. 3. Gross or micorscopic hematuria. 4. Enlarged epididymis with a beaded or thickened 5. A chronic draining scrotal sinus 6. Induration or nodulation of the prostate and thickening of one or both seminal vesicles. Clinical findings ? The diagnosis rests on the demonstration of tubercle bacilli in the urine by culture. ? The extent of the infection is determined by: 1. The palpable findings in the epididymises, prostate and seminal vesicles 2. The renal and ureteral lesions as revealed by IVP 3. involvement of the bladder as seen through the cystoscope 4. The degree of renal damage as measured by loss of function. 5. The presence of tubercle bacilli in one or both kidneys. Clinical findings A. Symptoms: ? There is no classic clinical picture of renal tuberculosis ? Most symptoms of this disease, are vesical in origin (cystitis) Clinical findings A. Symptoms: 1. Frequency: the earliest symptoms of renal tuberculosis may arise from secondary vesical involvement. 2. Pyuria: no bacteria is found in the culture of urine. 3. Hematuria: is occasionally found and is of either renal or vesical origin. 50~60%, gross hematuria: 10% 4. Pain and mass: dull ache in the flank. The passage of a blood clot, secondary calculi, or a mass of debris may cause renal and ureteral colic. 5. Some of the nonspecific plaints: vague generalized malaise, fatigability, lowgrade but persistent fever, and night sweats. Clinical findings B. Signs: 1. Evidence of extragenital tuberculosis may be found (lungs, bone, lymph nodes) 2. Kidney—usually no enlargemen
規(guī)章制度相關(guān)推薦
鄂ICP備17016276號-1