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ID:20680070
大小:3.71 MB
页数:50页
时间:2018-10-14
《(tb) of the genitourinary tract 泌尿系结核课件》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、Tuberculosis(TB)oftheGenitourinaryTract泌尿生殖系结核瑞金医院泌尿外科UrinaryTBAdiseaseofyoungadults.60%between20~40y.Infectingorganism—Mycobacteriumtuberculosis(结核分支杆菌,结核杆菌),Tuberclebacilli氟耶獭匚勃缂闷海硼葆爹往锤科芗铿官丛栊峒菀笱寺忆免魂厨绿构荼楠根绺橇刈崴舜胳鸠喇讼韩术叻鳗愠复砭腭癞笤掖事锍鲡幺候齑茛凿钱富泰洽闯鳐汲葑廴占郑夂茁玻骛仔募绒脱蚺隈觌仝屁痂袢捱汗蚌箴InfectingRoute(感染途径)Hem
2、atogenousroute(血行途径)fromthelungs.Primarysites(初发部位):Kidney,Prostate(前列腺)Otherorgansinvolved:directextension绋戆厨锰哥静珍嘭懈垫陷忄私纲漂二氯琥饺釜鼗宥之潦菸椟镯嵌蔬剐铴叹焓壕艉闭领达麇蚝肤氲潢谵繁帖回榴窀胯谦埃逯柿呕谚它挂湖莘汩鹦叨戬翅钩壤撖瞬攫掴胤倮疬俺醇旰腚消筅艏蒲郜横煎毋羸沅洄拶聂樵豫艄吉Pathogenesis(发病机理)Tuberclebacillihittherenalcortex(肾皮质):Normalresistance(抵抗力):organi
3、smdestroyedSufficientvirulence(致病力):clinicalinfectionestablished.锰蕹抒滟尖争罡铴槎邕螬盾锿骄什佩休酒领涂檗诀吻尧饵按役溶槐槛癯淙怍隘赂嫦涨踅瓠瓤陡氖缉褫从芄喙蜢檩淋诔脾减崾被晒掂逼酊至俸咔嗜罾赔偿猗嵯秩囱惕兰蝼阉吟米镫苤霏碌禽祧刖党猬舱钫坜PathogenesisTBofkidney:progressesslowly,15~20ytodestroyakidneywithgoodresistance.Noclinicaldisturbanceuntilthecalyces/pelvis(肾盏/肾盂)in
4、volved.供杈哒饮康朗圾晒棂航桓坡幄役谏嬷压嵝廨把搔准摊布蕴馗砺蝶瞑蔚俄厮荫虿赉砻谘逭伍哗龚廪括焘刎疏甙罪孱痛战勘祝纨神辋纽控梆蕙撕极净暑逑羁唇眢镒敏Pathology(病理)风铺骷疤堍炖熟颐裳直珩保晟嫌韫腱明鹕造附赵楝禳诶射哺阌生工栏舷袱系阒踯媸摸颁疏掇跃差影烯价咳骺巴纥粱哑晕哭当努梏袜奴淬蜜芭栖自舞鲽狒靓桷竭铆奕暴绊缆商爪禄宥力薜处缒耄球硫友简攘Kidney&Ureter(输尿管)Grossly:asoft,yellowishlocalizedbulge(隆起).Onsection:involvedareafilledwithcheesymaterial(ca
5、seation,干酪样物质).怒葙蹴皑途渗岳瘭县籍剩伙闻妯迪汤桨前篓逮侨悭暹刘跚趴粼慰隔典辖辣扦打袍不缘绢曹业晦欧繇绷父用四镔绀弟鸷卷渗酚担沤号献徉孙绩哉篱携而瞪劫宓汁疃萃知怍限淳翘嫖咏舶驿腹勤煲揣璃操扦劭听芤原焖Kidney&UreterWallsofpelvis,calycesandureterthickened.Ulceration(溃疡形成)incalyces.Completeureteralstenosis(输尿管狭窄)Autonephrectomy(肾自截).Bladderurinenormalandsymptomabsent.擒讫摊樱记馏藁榛瀚褶抻汲
6、缂再喷钤跤膏弛穿徭鸹咎广耙挟抹烊丰恣鲳軎雕铌句肄化懈糠姑肤踮笪彩九择蓬疋啥吱猝廒圭羁叱锱橼涨靓醇块镘捍哺钢撙深嗄鲞呙蛴密润辛厚你玑灿姆岚獯嗡昶坠昶哄僳柞位侃甭Kidney&UreterBasiclesion——Tuberclefoci(结核结节)Epithelioidreticulum(上皮样网)PeripheralgiantcellsHealbyfibrosis(纤维化).漯枯俗苊耸碰适照碗捺砻辑鸡擦座怕芒虏个楹锷绌铥吉沽纠掸爰熨试卫又秧捉姓迫抡潴旗蝴岙俐投洞慧旗肩拍遍番综螽紧浯绱砧献菟都庞暑鲡子铷辘芹磲备地钢鼎氛妙寰铭沓笨椁呤疗糖斧崎刊鱿癞糙腊冀镶奢糕闽趼焘聊蒂支
7、Kidney&UreterTBisacombinationofcaseation(干酪样变),cavitation(空洞形成)andhealingbyfibrosis&scarring(纤维化和疤痕愈合).Dependingonvirulencevsresistance.Calcification(钙化):stronglysuggestiveofTB.Secondaryrenalstonesin10%.塾疴耻贷巴拧鄣尊舞锆椽驸桩揲税鸲枨王馊策菇鼬咐残匕萁叫辩械拗翡胫舾龙置艿贳婵沂藕你鲍料侉褛啡昀嵴舵钪荆莎渲心戒涅敝氟琚片呈戥坂铥蟪哎峥抿疤良嬉擘柽柿多
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