泌尿器官结核病:叙述性综述和诊断和治疗建议
André Avarese Figueiredo1, José Carlos Truzzi2, Augusto Azevedo Barreto1
1Faculdade de Medicina da Universidade Federal de Juiz de Fora - UFJF - Juiz de Fora, MG, Brasil.
概括
诊断泌尿腺结核 (UGT) 需要高度怀疑,因为非特异性症状. 早期干预药物治疗和尿路问题的外科重建改善了结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 泌尿器官结核病 (UGT) 呈现出各种各样的,往往非特异性的症状.
- 准确的诊断和及时的治疗对于管理UGT至关重要.
研究的目的:
- 审查泌尿器官结核病 (UGT) 的关键方面.
- 为UGT诊断和治疗提供基于证据的建议.
主要方法:
- 在PubMed,Embase和SciELO数据库中进行了全面的文献审查.
- 分析了过去60年发表的研究.
- 使用修改后的GRADE系统来对证据进行分类,制定了建议.
主要成果:
- 怀疑UGT的症状包括持续的出血,无菌的发烧,尿路狭窄/加厚,或慢性前列腺炎/表皮膜炎.
- 尿道细菌学测试显示敏感度低;负结果并不排除UGT.
- 建议早期干预 (≤1个月) 用双J导管或管切除用于尿管狭窄;对于小狭窄,内镜治疗是可选的.
- 膀增大适用于收缩的膀 (<100毫升容量),大多数患者会恢复自发排泄.
结论:
- UGT诊断依赖于高度的临床怀疑和特征性的放射学发现.
- 六个月的药物治疗可以开始,即使没有确定的诊断确认.
- 对于尿管狭窄和收缩的膀,手术重建是必要的.
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