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肾输尿管结石病的误诊,不外两种情况。一种是漏诊。病人有肾输尿管结石,由于临床表现不典型,仅偶感上腹部或腰背部胀满不适,或无意中在腰背部或上腹部发现肿块,而长期被诊为溃疡病、胆石病、肝脾肿大(实为梗阻性肾积水)等;或由于反复腰痛尿频,尿检有红、白细胞,而当作单纯性肾盂肾炎、尿路结核等疾病处理。经腹部平片发现肾、输尿管区有钙影,再通过泌尿科的系统检查而明确诊断。另一种是误诊,病人没有肾输尿管结石,无尿路疾病病史,也无有关症状体征可查,偶因某种原因,摄取腹部平片时,在肾输尿管区见到了某种钙影。乍看起来,酷似结石。应仔细思考,警惕混珠。经系统检查,排除了结石,而该种钙影实为尿路以外之物。田医师等报告的1例,属后一种情况,系对腹后钙影缺乏混珠之虑,未经反复检查验证,轻率结论所致。泌尿外科的常规作法是:凡遇腹部平片上显示输尿管走行区有钙影,而病人却缺乏相关症状、体征及化验发现时,为了鉴别诊断,必须进行输尿管插管,摄取带管的正、侧位腹片,再辅以逆行或
Kidney ureteral calculi misdiagnosis, but two cases. One is missed diagnosis. Patients with renal ureteral calculi, due to clinical manifestations of atypical, only occasional upper abdomen or lower back fullness discomfort, or inadvertently found in the lower back or upper abdomen, and long-term was diagnosed as ulcer disease, gallstone disease, hepatosplenomegaly (In fact, obstructive hydronephrosis), etc .; or because of frequent recurrent low back pain urinalysis, red, white blood cells, and as a simple pyelonephritis, urinary tract tuberculosis and other diseases. The abdominal plain film found kidney, ureter area has calcium shadow, and then through the urological system to confirm and a clear diagnosis. The other is misdiagnosed, the patient does not have renal ureteral calculi, no history of urinary tract disease, there is no relevant symptoms and signs can be checked, even for some reason, when taking abdominal plain film, in the ureter area to see some kind of calcium shadow. At first glance, it looks like a stone. Should be careful thinking, vigilance mixed beads. After systematic examination, ruled out stones, and the kind of calcium shadow is actually outside the urinary tract. Dr. Tian and other reports of a case, which is the latter case, the Department of Abdominal Ca deficiency lack of mixed consideration, without repeated examination and verification, reckless conclusions. Urology routine practice is: where the case of abdominal plain film showing the presence of calcium in the ureter walking area, but the patient lacks the relevant symptoms, signs and laboratory findings, in order to differentiate the diagnosis, must be ureteral intubation, Abdominal tablets, supplemented by retrograde or