Rous S N
Prim Care. 1985 Dec;12(4):647-59.
In summary, hematuria, either gross or microscopic and with or without any accompanying symptoms, should always alert the clinician to the possibility of serious urologic disease and should virtually always trigger a thorough urologic investigation. This can be done by immediate referral to the urologist, or it can be done by the primary care physician initiating the diagnostic work-up in children by obtaining studies for acute poststreptococcal glomerulonephritis and in adults by obtaining excretory urograms with physiologic voiding films and also by urine cytologic studies and urine cultures. Appropriate referral to a urologist can then be made for additional studies that might be indicated, such as cystoscopy and cystourethroscopy and for meticulous follow-up of any abnormal findings. The physician who delays or defers a careful investigation into the cause of a given patient's hematuria (gross or microscopic) does the patient a disservice at best and, at worst, may inadvertently permit a significant disease process to become more extensive.
总之，无论是肉眼血尿还是镜下血尿，无论有无伴随症状，都应始终提醒临床医生注意严重泌尿系统疾病的可能性，并且几乎总是需要引发全面的泌尿系统检查。这可以通过立即转诊给泌尿科医生来完成，或者也可以由初级保健医生进行诊断性检查，在儿童中通过获取急性链球菌感染后肾小球肾炎的相关检查，在成人中通过获取排泄性尿路造影及生理性排尿造影，以及进行尿液细胞学检查和尿培养来完成。然后可以适当转诊给泌尿科医生进行可能需要的其他检查，如膀胱镜检查和膀胱尿道镜检查，并对任何异常发现进行细致的随访。延误或推迟对特定患者血尿（肉眼或镜下）病因进行仔细检查的医生，往好里说是对患者不利，往坏里说可能会无意中使严重疾病进程变得更广泛。
