Prior J, Guignard J P
Département médicochirurgical de pédiatrie, centre hospitalier universitaire Vaudois, Lausanne, Suisse.
Arch Pediatr. 1998 Jul;5(7):799-807. doi: 10.1016/s0929-693x(98)80071-7.
The discovery of hematuria in a child should lead the pediatrician to a methodical evaluation of the patient based on an extensive history and comprehensive physical examination. The microscopic examination of the urine is the cornerstone in the evaluation process and may suggest the origin of the hematuria. For instance, red blood cell casts indicate glomerular lesions and rule out the need for further urological examinations. According to the type of hematuria and the associated symptoms, a complete and immediate evaluation is sometimes necessary. This article presents a decisional tree to help the pediatrician to investigate an hematuria and to refer the child to a specialist, when needed.
儿童血尿的发现应促使儿科医生根据详尽的病史和全面的体格检查对患者进行系统评估。尿液显微镜检查是评估过程的基石,可能提示血尿的来源。例如,红细胞管型提示肾小球病变,无需进一步进行泌尿外科检查。根据血尿类型和相关症状,有时需要进行完整且即时的评估。本文提供了一个决策树,以帮助儿科医生对血尿进行调查,并在必要时将患儿转诊给专科医生。