泌尿系统结核的诊断与治疗专家共识

doi:10.19982/j.issn.1000-6621.20250058

摘要/Abstract

摘要：

泌尿系统结核起病隐匿,临床表现缺乏特异性,常被延误诊断,导致肾功能减退,甚至出现终末期肾功能衰竭。同时,泌尿系统结核的治疗方式包括全身抗结核药物治疗联合局部治疗、手术治疗和中西医结合治疗等,选择合适的治疗手段才有可能最大程度地保留患者的肾功能,改善预后。目前,对于泌尿系统结核的诊疗方案,我国尚缺乏相关合理的指导性文件。为规范我国泌尿系统结核的诊断和治疗,提高临床医师对泌尿系统结核的诊疗水平,使患者早日治愈,减少肾功能损伤,中国人民解放军总医院第八医学中心结核病医学部、《中国防痨杂志》编辑委员会和中国医疗保健国际交流促进会结核病防治分会基础和临床学部联合组织专家,结合我国泌尿系统结核诊断及治疗的经验和方法,以及国外诊断和治疗相关研究成果,共同制定《泌尿系统结核的诊断与治疗专家共识》。本共识概述了泌尿系统结核的流行病学特征、病理生理过程和主要的临床表现,详细介绍了泌尿系统结核的常用检查方法,提出了诊断标准和需要鉴别诊断的相关疾病,并对该病的全身抗结核药物治疗、局部治疗及手术治疗的方案及适应证等提出了具体的治疗建议,旨在为临床医师对泌尿系统结核患者进行精准诊断和合理治疗提供参考依据。

关键词: 结核, 泌尿生殖系统, 诊断, 治疗学, 总结性报告(主题)

Abstract:

Urological tuberculosis has an insidious onset and lacks specificity in clinical manifestations, which often leads to delayed diagnosis, resulting in decline in renal function or even end-stage renal failure. Treatment of urological tuberculosis includes systemic anti-tuberculosis drug therapy combined with local therapy, surgical intervention, and integrated traditional Chinese and Western medicine, etc. The selection of appropriate treatment methods is essential to maximize the preservation of renal function and improve the prognosis of the patients. At present, there is a lack of relevant and reasonable guiding documents for the diagnosis and treatment program of urological tuberculosis in China. To standardize the diagnosis and treatment of urological tuberculosis and improve the level of clinicians so that the patients can be cured early and damage to renal function can be reduced, Senior Department of Tuberculosis, the Eighth Medical Center of the Chinese People’s Liberation Army General Hospital, the Editorial Board of Chinese Journal of Antituberculosis, and Basic and Clinical Specialty Committees of Tuberculosis Control Branch of China International Exchange and Promotive Association for Medical and Health Care jointly organized experts to formulate the “Expert consensus on the diagnosis and treatment of urological tuberculosis”, based on the experience and methods of diagnosis and treatment of urological tuberculosis in China, as well as the relevant research achievements in diagnosis and treatment abroad. This consensus integrates China’s diagnostic and therapeutic experience and methods with international research achievements in the diagnosis and treatment of urological tuberculosis. This consensus outlines the epidemiological characteristics, pathophysiological process, main clinical manifestations, and common examination methods of urological tuberculosis, puts forward the diagnostic criteria and differential diagnosis, and gives specific treatment suggestions on the program and indications for systemic anti-tuberculosis drug therapy, local treatment, and surgical intervention of this disease. It aims to provide clinicians with a scientific and practical reference for accurate diagnosis and rational treatment of the patients with urological tuberculosis.

Key words: Tuberculosis, urogenital, Diagnosis, Therapeutics, Consensus development conferences as topic

中图分类号:

中国人民解放军总医院第八医学中心结核病医学部《中国防痨杂志》编辑委员会, 中国医疗保健国际交流促进会结核病防治分会基础和临床学部. 泌尿系统结核的诊断与治疗专家共识[J]. 中国防痨杂志, 2025, 47(5): 546-558. doi: 10.19982/j.issn.1000-6621.20250058

Senior Department of Tuberculosis, the 8th Medical Center of Chinese PLA General Hospital, Editorial Board of Chinese Journal of Antituberculosis, Basic and Clinical Speciality Committees of Tuberculosis Control Branch of China International Exchange and Promotive Association for Medical and Health Care. Expert consensus on the diagnosis and treatment of urological tuberculosis[J]. Chinese Journal of Antituberculosis, 2025, 47(5): 546-558. doi: 10.19982/j.issn.1000-6621.20250058

图/表 2

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