Thaller T R, Wang L P
University of Kansas Medical Center, Kansas City, USA.
Am Fam Physician. 1999 Sep 15;60(4):1143-52, 1154.
In patients without significant urologic symptoms, microscopic hematuria is occasionally detected on routine urinalysis. At present, routine screening of all adults for microscopic hematuria with dipstick testing is not recommended because of the intermittent occurrence of this finding and the low incidence of significant associated urologic disease. However, once asymptomatic microscopic hematuria is discovered, its cause should be investigated with a thorough medical history (including a review of current medications) and a focused physical examination. Laboratory and imaging studies, such as intravenous pyelography, renal ultrasonography or retrograde pyelography, may be required to determine the degree and location of the associated disease process. Cystourethroscopy is performed to complete the evaluation of the lower urinary tract. Microscopic hematuria associated with anticoagulation therapy is frequently precipitated by significant urologic pathology and therefore requires prompt evaluation.
在没有明显泌尿系统症状的患者中，偶尔会在常规尿液分析时检测到镜下血尿。目前，不建议对所有成年人进行尿试纸法镜下血尿常规筛查，因为这一发现具有间歇性，且相关泌尿系统重大疾病的发病率较低。然而，一旦发现无症状镜下血尿，应通过全面的病史询问（包括当前用药情况回顾）和重点体格检查来调查其病因。可能需要进行实验室和影像学检查，如静脉肾盂造影、肾脏超声或逆行肾盂造影，以确定相关疾病过程的程度和位置。需进行膀胱尿道镜检查以完成下尿路评估。与抗凝治疗相关的镜下血尿通常由重大泌尿系统病变引起，因此需要及时评估。
