泌尿、男生殖系結(jié)核-文庫(kù)吧資料
2025-06-01 12:13本頁(yè)面
【正文】 disease progress, a caseous breakdown of tissue occurs until the entire kidney is replaced by cheesy material. ? Calcium may be laid down in the reparative process. ? The ureter undergoes fibrosis and tends to be shortened and straightened. This change leads to a “golfhole” (gaping) ureteral orifice, typical of an inpetent valve. Tuberculosis of kidney and ureter Tuberculosis of kidney and ureter Tuberculosis of kidney Pathogenesis B. bladder: ? Vesical irritability develops as an early clinical manifestation of the disease as the bladder is bathed by infected material. ? Tubercles form later, usually in the region of the involved ureteral orifice, and ulcerate—bleeding. ? Bladder bees fibrosed and contracted, this leads to marked frequency. ? Ureteral reflux or stenosis and hydronephrosis. Pathogenesis C. Prostate and seminal vesicles: ? The passage of infected urine through the prostatic urethra leads to invasion of the prostate and one or both seminal vesicles. ? There is no local pain. ? The primary hematogenous lesion in the genitourinary trace is in the prostate. ? Prostatic infection can ascend to the bladder and descent to the epididymis. Pathogenesis D. Epididymis and testis: ? Tuberculosis of the prostate can extend the epididymis. ? This is a slow process, there is usually no pain. ? If the epididymal infection is extensive and an abscess forms, it may rupture through the scrotal skin, thus establishing a permanent sinus, or it may extend into the testicle. Pathology ? 病理型腎結(jié)核 : ? 結(jié)核早期病變 , 結(jié)核菌通過血行傳播至腎皮質(zhì) —結(jié) 核結(jié)節(jié)和結(jié)核肉芽腫形成。 Urologic and Male Genital Tuberculosis Yi Lin Department of urology Tianjin Medical University 概 述 ? 泌尿、男生殖系結(jié)核 (urologic and male genital tuberculosis) ? 結(jié)核桿菌侵犯泌尿、男性生殖器官引起的慢性特異性感染。 ? 約占全部肺外結(jié)合的 14% ? 與經(jīng)濟(jì)落后、醫(yī)療水平底有關(guān) ? 好發(fā)年齡 20~40歲青壯年 ? 男性大于女性， 2： 1左右 概 述 ? 原發(fā)性結(jié)核病 : 首次感染結(jié)核菌 , 引起的結(jié)核病 肺結(jié)核 ? 繼發(fā)性結(jié)核病 : 有結(jié)核菌感染后 , 已建立細(xì)胞免疫和變態(tài)反應(yīng)后發(fā)生的結(jié)核病 . ? 發(fā)病機(jī)理 ? 人體首次感染結(jié)核菌 —機(jī) 體無(wú)免疫力 —巨 噬細(xì)胞不能殺死結(jié)核菌 —結(jié) 核菌蔓延 —經(jīng) 淋巴或血液播散到全身 —在 各組織中著床 —潛 伏灶 —一 般情況下不發(fā)病 —機(jī) 體免疫力地下時(shí)或營(yíng)養(yǎng)不良時(shí) —潛 伏菌大量繁殖 —發(fā) 病 概 述 ? 感染途徑： 4種 1. 血性感染：最常見 2. 接觸感染：通過性生活或污染物傳播，少見 3. 淋巴感染：罕見 4
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