Cuttino J T, Clark R L, Feaster S H, Zwicke D L
AJR Am J Roentgenol. 1987 Sep;149(3):527-8. doi: 10.2214/ajr.149.3.527.
To determine the efficacy of investigating gross hematuria in anticoagulated patients, records were reviewed of 24 patients who had gross hematuria while being treated with warfarin for various thromboembolic disorders. All had IV urography, and half had cystoscopy. Sources of bleeding were found in seven (29%) of 24 patients by IV urography and in five (42%) of 12 patients by cystoscopy. Abnormalities considered responsible for bleeding included renal stones (four), transitional cell carcinoma (one), calcified renal mass (one), lymphoma (one), bladder tumors (two), hemorrhagic cystitis (two), and a bleeding prostate tumor (one). Additionally, an enlarged prostate was the only abnormal finding in five patients. If an enlarged prostate is considered a source of bleeding, the workup that included both IV urography and cystoscopy identified a cause of bleeding in 17 (71%) of 24 patients. The results suggest that IV urography and cystography are warranted in patients who take anticoagulants and who have gross hematuria.
为了确定对接受抗凝治疗的肉眼血尿患者进行检查的效果，回顾了24例在因各种血栓栓塞性疾病接受华法林治疗期间出现肉眼血尿的患者的记录。所有患者均接受了静脉尿路造影，半数患者接受了膀胱镜检查。通过静脉尿路造影在24例患者中的7例（29%）发现了出血来源，通过膀胱镜检查在12例患者中的5例（42%）发现了出血来源。被认为是出血原因的异常情况包括肾结石（4例）、移行细胞癌（1例）、钙化肾肿物（1例）、淋巴瘤（1例）、膀胱肿瘤（2例）、出血性膀胱炎（2例）和出血性前列腺肿瘤（1例）。此外，前列腺增大是5例患者中唯一的异常发现。如果将前列腺增大视为出血来源，那么包括静脉尿路造影和膀胱镜检查在内的检查在24例患者中的17例（71%）中确定了出血原因。结果表明，对于服用抗凝剂且出现肉眼血尿的患者，进行静脉尿路造影和膀胱造影是必要的。
