無症狀顯微性血尿的臨床意義

The Clinical Significance of Asymtomatic Microscopic Hematuria

楊國政(Kuo-Cheng Yang) ； 吳錫金(Hsi-Chin Wu) ； 張兆祥(Chao-Hsiang Chang) ； 陳國樑(Kuo-Liang Chen)

《Mid-Taiwan Journal of Medicine》 8卷s_2期 (2003/12) Pp. s108-s113

https://doi.org/10.6558/MTJM.2003.8(s_2).7

摘要

目的：無症狀的顯微性血尿通常是在常規的尿液檢查中意外發現，其中可能潛藏著一些有意義泌尿系統的疾病，我們對中部地區這些無症狀的顯微性血尿的病人做了完整的泌尿系統檢查，並評估其中所隱藏的疾病。
方法：從公元1997到2001年，我們先排除了具有其它會引起血尿問題的病人，最後我們共收集了84個門診無症狀的顯微性單一血尿病人，他們都做了一系列的檢查，包括尿液常規檢查，尿液細胞學檢查，靜脈腎盂攝影或腎臟超音波，和膀胱鏡檢查。
結果：這84個病人中，有26個男性和58個女性病人，平均年齡48.8歲（13到83歲）。其中有63個（佔75%）結果是正常的；而有異常發現者有21人（佔25%）。在這21個病人中，有12個為結石病人（佔14.2%，其中2個為鹿角狀結石，2個為輸尿管結石，8個為小的腎結石），1個有膀胱移形上皮細胞癌（1.2%），6個膀胱頸息肉（7.1%），2個膀胱憩室（2.4%），1個腎囊腫（1.2%），1個尿道狹窄（1.2%）和1個膀胱微血管擴張（1.2%）。有5個病人更進一步接受了手術，2個經皮穿腎取石術，2個輸尿管鏡碎石術，1個經尿道膀胱腫瘤切除術。
結論：會引起顯微性血尿的疾病很多，從一些非特異性的偶然發現，到明顯而有意義且可能會威脅生命安全的疾病都可能發生。當病人發現了無症狀的顯微性血尿時，應該做進一步完整的泌尿系統檢查，可以早期發現潛在的疾病，早期進行治療。

關鍵字

泌尿上皮癌 ； 膀胱鏡 ； 靜脈腎盂攝影 ； 腎絲球疾病

並列摘要

Objectives: Asymptomatic microscopic hematuria is often discovered as part of a routine examination; some of these patients are likely to have clinically significant diseases and a full urologic evaluation is justified. To address the signifcance of asymptomatic microscopic hematuria, OPD patients with asymptomatic microscopic hematuria were evaluated for the underlying urologic diseases.
Methods: We retrospectively evaluated the data of 84 patients with asymptomatic microscopic hematuria, but without other urinary symptoms, from 1999 to 2001. All patients received a series of studies including urine analysis, urine cytology, intravenous urography (IVU) or renal ultrasonography (US) and cystoscopy.
Results: A total of 84 patients were enrolled. There were 26 men and 58 women agerange, 13 to 83 years (mean: 48.8). Sixty-three patients (75%)showed normal findings. Twenty-one patients (25%) had abnormal findings which included 12 (14.2%) stones (2 staghorn stones, 2 ureteral stones and 8 small renal stones), l (1.2%) urinary bladder TCC, 1 (1.2%) renal cyst, 6 (7.1%) bladder neck polyps, 2 (2.4%) urinary bladder diverticulums, l (1.2%) telangiectasis and l (1.2%) urethra stricture. In all 84 patients, 3 patients had two problems. They received further operations for their underlying disease: TUR-Bt (1), PCNL (2) and URSL (2).
Conclusions: Causes of asymptomatic microscopic hematuria range from minor, incidental findings that do not require treatment to highly significant lesions that immediately threaten the patient's life. Patients with asymptomatic microscopic hematuria should undergo an appropriate evaluation because it will often determine the cause of the hematuria.

並列關鍵字

cystoscopy ； Glomerular disease ； IVP ； urothelial cancer