Peterson Leah M, Reed Henry S
Smoky Hill Family Medicine Residency Program, Salina, KS, USA.
Internal Medicine/Nephrology, Mowery Clinic, 737 East Crawford, Salina, KS 67401, USA.
Prim Care. 2019 Jun;46(2):265-273. doi: 10.1016/j.pop.2019.02.008. Epub 2019 Apr 1.
Hematuria is common in the primary care setting. It is classified as either gross or microscopic. Hematuria warrants a thorough history and physical to determine potential causes and assess risk factors for malignancy. Risk of malignancy with gross hematuria is greater than 10%, and prompt urologic referral is recommended. Microscopic hematuria most commonly has benign causes, such as urinary tract infection, benign prostatic hyperplasia, and urinary calculi. If no benign cause for microscopic hematuria is found, the work-up includes laboratory tests to rule out intrinsic renal disease, imaging of the urinary tract, and referral to nephrology and urology subspecialists.
血尿在基层医疗环境中很常见。它分为肉眼血尿或镜下血尿。血尿需要详细的病史和体格检查，以确定潜在病因并评估恶性肿瘤的风险因素。肉眼血尿的恶性肿瘤风险大于10%，建议及时转诊至泌尿外科。镜下血尿最常见的病因是良性的，如尿路感染、良性前列腺增生和尿路结石。如果未发现镜下血尿的良性病因，检查包括实验室检查以排除内在肾脏疾病、泌尿系统影像学检查，以及转诊至肾脏科和泌尿外科专科医生。
