? 發問時間: 社會與文化語言 · 1 0 年前

專業醫學英文~麻煩高手翻譯~不要翻譯軟體翻的喔~謝謝

The single most important test in the evaluation of

hematuria is the microscopical analysis of urine,

because it often distinguishes glomerular from

nonglomerular bleeding (Fig. 1). If the findings indicate

a glomerular site of bleeding, no urologic

evaluation is necessary. Documentation of renal insufficiency

or proteinuria warrants referral to a nephrologist

for evaluation and possible renal biopsy;

referral should be prompt if a second measurement

of serum creatinine is abnormal or higher than the

first. However, renal biopsy in a patient with microscopic

hematuria unaccompanied by clinically significant

proteinuria or renal insufficiency is not

supported by the limited data that are available. In

a study involving 75 patients with isolated microscopic

hematuria who underwent renal biopsy, 36

percent had thin basement membrane disease, and

23 percent had IgA nephropathy — findings that

made little difference in their care

If a glomerular source is ruled out or considered

unlikely on the basis of the clinical presentation, the

upper urinary tract should be imaged. The goal is to

detect any neoplasms, including renal-cell carcinoma

and the less prevalent transitional-cell carcinomas

of the renal pelvis and ureters, urolithiasis,cystic disease,

and obstructive lesions.

Excretory urography has been used routinely to examine the

upper urinary tract in most studies of microscopic hematuria.

Ultrasonography is safer, does not involve

exposure to intravenous radiographic contrast

medium, is appropriate for use during pregnancy,

and is less expensive.

Ultrasonography, however,may be limited in its detection

of solid tumors thatare less than 3 cm in diameter.

1 個解答

評分
  • 1 0 年前
    最佳解答

    用來評估血尿最重要的單一測試就是尿液的顯微鏡分析,因為它通常可以分辨是腎絲球損傷或是非腎絲球損傷的出血(這你應該比我熟吧,我就不解釋原理啦~),如果檢查結果是腎絲球處的出血,那後續的泌尿學評估就不用做了。

    如果有腎功能不足或是蛋白尿就必須立刻轉診給腎臟科的醫生來做評估或是做腎臟切片,特別是那些血清肌酸(用來評估腎功能好不好的東西,值越高腎功能越差)第二次的測量值不正常或比第一次測量值高的病人。

    然而,對臨床上沒有伴隨顯著蛋白尿或腎功能不足的顯微性血尿的病人做腎切片,是不被目前有限而可取得的資料支持的(意思是沒有蛋白尿或腎功能不足的顯微性血尿的病人,目前不建議亂做腎切片)。

    有一個研究對單純只有顯微性血尿而又有做腎切片的75個病人做調查,發現36%的病人有腎絲球基底膜腎病變,而23%的病人有IgA腎病,研究結果和他們所關心的好像沒有什麼很大的不同。

    如果腎絲球疾病這個病因被排除,或是根據臨床症狀覺得病人不可能是腎絲球病變的話,我們就應該做做上泌尿道的影像檢查,檢查的目的是偵測任何可能的腫瘤(包括腎細胞癌和較不常見的,發生在腎盞或輸尿管的移行上皮癌)、腎結石、囊性疾病,和阻塞性的損傷。

    排洩性尿路攝影(就是IVP)在大多數顯微性血尿的研究中都常規地拿來檢查上泌尿道。

    超音波對於孕婦來說比較安全(和靜脈內放射線照影之顯影劑比起來,超音波沒有輻射性,不會致畸胎),而且也比較便宜。

    但是超音波的缺點就是不太能偵測到直徑3公分以下的固體腫瘤。

    中間有一兩句翻的怪怪的,多多包含啦~~

    參考資料: 拼了!!下一篇~~
還有問題?馬上發問,尋求解答。