Van Savage J G, Fried F A
Department of Surgery, University of North Carolina, Chapel Hill, USA.
J Urol. 1995 May;153(5):1594-6.
We studied prospectively 32 consecutive patients with new onset of gross or microscopic hematuria while on anticoagulant therapy. Of the patients 19 men and 11 women (mean age 65 years) underwent urological evaluation. Of 6 patients with microscopic hematuria 3 with nephrolithiasis subsequently underwent extracorporeal shock wave lithotripsy. Two of 24 patients (7%) with gross hematuria had neoplastic disease invading the bladder, 1 had benign prostatic hyperplasia requiring resection, 1 had urethral stricture, 1 had ureteropelvic junction obstruction and 1 had nephrolithiasis. Thus, significant urinary tract disease was present in 9 patients (30%). Hematuria resolved in more than 90% of the patients after treatment. Based upon these observations, we believe that gross or microscopic anticoagulant associated hematuria is frequently precipitated by a significant genitourinary pathological condition and its prompt evaluation is recommended.
我们前瞻性地研究了32例在接受抗凝治疗时新发肉眼血尿或镜下血尿的连续患者。其中19名男性和11名女性患者（平均年龄65岁）接受了泌尿外科评估。在6例镜下血尿患者中，3例患有肾结石，随后接受了体外冲击波碎石术。24例肉眼血尿患者中有2例（7%）患有侵犯膀胱的肿瘤性疾病，1例患有需要切除的良性前列腺增生，1例患有尿道狭窄，1例患有输尿管肾盂连接处梗阻，1例患有肾结石。因此，9例患者（30%）存在明显的泌尿系统疾病。治疗后超过90%的患者血尿消失。基于这些观察结果，我们认为肉眼血尿或镜下血尿与抗凝剂相关，常常由明显的泌尿生殖系统病理状况引发，建议对此进行及时评估。
