Shen Xinying
Adult Acute Care Nurse Practitioner Program, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
J Am Acad Nurse Pract. 2010 Apr;22(4):186-91. doi: 10.1111/j.1745-7599.2010.00491.x.
To present a logical and cost-effective diagnostic approach for primary care physicians to a common symptom, hematuria.
Selected research, review articles, as well as medical textbooks and current government guidelines.
Dipstick test and microscopic urinalysis are two common screening tests for hematuria. Once hematuria is discovered, its etiology should be investigated through a comprehensive history, a focused physical examination, laboratory studies, and radiographic imaging. Microscopic urinalysis is simple yet important in distinguishing glomerular from nonglomerular sources of bleeding. Intravenous urography, renal ultrasonography, or computed tomography may be needed to determine the location and characteristics of lesions. Cytoscopy is important in evaluating lower urinary tract lesions.
Hematuria is a frequently encountered symptom that has a broad differential diagnosis ranging from insignificant etiology to potentially life-threatening neoplastic lesions. A systematic method can be useful in efficiently and cost-effectively managing hematuria. Early and appropriate diagnosis of this common symptom results in improved clinical outcomes.
为基层医疗医生提供一种针对常见症状血尿的合理且具成本效益的诊断方法。
选定的研究、综述文章、医学教科书及现行政府指南。
试纸条检测和显微镜下尿液分析是血尿的两种常见筛查方法。一旦发现血尿，应通过全面的病史、重点体格检查、实验室检查及影像学检查来探究其病因。显微镜下尿液分析在区分肾小球性与非肾小球性出血来源方面虽简单却很重要。可能需要静脉肾盂造影、肾脏超声或计算机断层扫描来确定病变的位置和特征。膀胱镜检查对评估下尿路病变很重要。
血尿是一种常见症状，其鉴别诊断范围广泛，从无关紧要的病因到可能危及生命的肿瘤性病变。一种系统的方法有助于高效且具成本效益地处理血尿。对这种常见症状进行早期且恰当的诊断可改善临床结局。
