- 期刊
- OpenAccess
Hematuria: Analysis of 738 Outpatients
血尿：738例病人的回溯性研究
並列摘要
No universal consensus on the approach to hematuria has been established up to present. We performed a retrospective analysis of 738 outpatients with hematuria to evaluate the common etiology and diagnostic algorithm in these patients. All outpatient clinic hematuria patients between January 1999 and April 1999 were reviewed. Demographic data regarding age and gender were recorded, and the diagnostic studies were analyzed included urinalysis, urine RBC morphology, urine calcium/creatinine ratio, urine cytology, urological image and cystoscopy. Among the 738 patients, 49 (6.6%) patients were diagnosed as highly significant lesions (malignancy), 299 patients (40.5%) had moderately significant lesions and 103 patients (14.0%) showed insignificant lesions. (1) Among 49 cancer patients, 4 were below 40 years and 1 of these 4 cancer patients presented with asymptomatic microscopic hematuria (microhematuria). (2) Two cancer patients showed 3 or less red blood cells per high power field in all urinalysis specimens before cancers were proved. (3) the efficacy rate of combining KUB and renal sonography were almost higher than IVU alone. (4) Cystoscopy was able to reveal bladder cancer even in the asymptomatic microhematuria patients younger than 40 years, but IVU was not. (5) Analysis of RBC morphology was performed in only 7.4% patients. Urine calcium/creatinine ratio was performed in 11.5% patients. No patient was screened for 24 hours uric acid excretion. Complete investigative procedure still should be done for elderly (＞40 years) patients. For those under 40 years with asymptomatic microhematuria, cystoscopy also should be considered. IVU probably can be replaced by KUB and renal sonography for patients younger than 40 years with microscopic hematuria. Urine calcium/creatinine ratio, 24 hours uric acid excretion and urine RBC morphology should be included in the work-up list.