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1 病例介绍患者女性,24岁.右图、腹部胀痛1年,高热1天(体温40.2℃).无尿频,尿急,尿痛.无血尿,无恶心、呕吐,大便正常.检查:右肾区有轻度叩击痛,腹部沿输尿管走行有压痛,无反跳痛.腹部饱满,未明显扪及包块.实验室检查,尿常规:蛋白±,白细胞1～2个/HP,红细胞1～3个/HP,血常规:血红蛋白149 g/L,白细胞10×10~9/L,中性60%,淋巴40%,血沉40mm/h,B超:腹膜后探及巨大包块,上界达右肾后,下界达盆腔,位于右腰大肌之前方,与右肾、肝脏界线清楚,B超引导下穿刺抽出乳黄色液体80 ml,穿刺液常规检查:比重1.025,雷瓦他试验强阳性,细胞总数1.5 ×10~5,白细胞13×10~5.普通培养未见细菌生长,涂片找结核杆菌(一).胸腰椎及骨盆片未见异常,次日行脓肿切开引流术,引流脓液1100 ml,安置双套管
1 Case Description Female patients, 24 years old. Right, abdominal pain for 1 year, 1 day fever (body temperature 40.2 ℃.) Frequent urination, urgency, dysuria. No hematuria, no nausea, vomiting, stool normal. There was slight percussion pain in the kidney area, tenderness in the abdomen along the ureter, no rebound tenderness, full abdomen and no obvious palpable mass.Laboratory examination, urine routine: protein ±, 1 ~ 2 white blood cells / HP, red blood cells 1 ~ 3 / HP, hemoglobin 149 g / L, white blood cells 10 × 10 ~ 9 / L, 60% neutral, lymphatic 40%, erythrocyte sedimentation rate 40mm / h, B ultrasound: retroperitoneal exploration and huge mass, Upper bound to the right kidney, the lower bound of the pelvis, located in front of the right psoas muscle, with the right kidney and liver clear line, B-guided puncture out of milk liquid 80 ml, puncture fluid routine examination: the proportion of 1.025, Strong positive test, the total number of cells 1.5 × 10 ~ 5, white blood cells 13 × 10 ~ 5. No ordinary bacterial growth, smear Mycobacterium tuberculosis (a). Thoracolumbar and pelvic films were normal, the next day abscess incision Drainage, drainage pus 1100 ml, placement of double cannula