Department of Urology, S287, 300 Pasteur Drive, Stanford, CA 94305-5118, USA.
Nat Rev Urol. 2010 Apr;7(4):189-94. doi: 10.1038/nrurol.2010.27. Epub 2010 Mar 9.
Asymptomatic, atraumatic hematuria is a worrisome clinical sign for a patient that usually prompts a visit to a urologist. Hematuria is classified as microscopic versus gross; the evaluation for gross hematuria differs from that for microscopic hematuria, and the most important differentiating factor is the patient's age. The major causes of hematuria differ between children and adults, and the evaluation should reflect this. Renal disease is more common in children and malignancy more common in adults. The application and utility of laboratory tests, radiological studies, and cystoscopy are well established in adults but are more variable in children. Follow-up of hematuria after a negative evaluation is becoming more limited in adults but should be routine for children.
无症状、无创伤性血尿是患者令人担忧的临床征象,通常会促使其就诊于泌尿科医生。血尿分为镜下血尿和肉眼血尿;肉眼血尿的评估与镜下血尿不同,最重要的鉴别因素是患者的年龄。血尿的主要病因在儿童和成人中有所不同,评估也应反映这一点。肾脏疾病在儿童中更为常见,而恶性肿瘤在成人中更为常见。实验室检查、影像学研究和膀胱镜检查在成人中的应用和实用性已得到充分确立,但在儿童中则更为多变。在阴性评估后对血尿进行随访在成人中变得越来越受限制,但对儿童则应常规进行。