Gross hematuria: how does hematuria have blood to return a responsibility

summary

Urine with blood is hematuria, also known as hematuria. Normally, there are no red blood cells in the urine. In medicine, the patient's urine is centrifuged and precipitated and examined with a microscope. If there are more than 5 red blood cells in each high power field, it is called hematuria. If the red blood cells are only detected under the microscope, and the eyes can not see the urine with blood, it is called microscopic hematuria; if the eyes can see that the urine is "meat washing water sample" or with blood color, and even there are blood filaments or blood clots in the urine, it is called gross hematuria. What's the matter with blood in urine.

Gross hematuria: how does hematuria have blood to return a responsibility

First: hematuria is often caused by diseases of urinary organs. Human urine is produced in the kidney, through the renal pelvis, ureter, bladder, urethra discharge, all these organs have a disease, bleeding, can cause hematuria. Common causes of hematuria are nephritis, urinary tract infection, hemorrhagic cystitis, urinary calculi, renal tuberculosis, renal tumor, kidney and urethral injury and so on. Hematuria is one of the main symptoms of these diseases. Differential diagnosis of hematuria: when micturition begins to be hematuria, and the latter segment of urine is normal, it is generally urethral disease; if micturition begins to be normal, hematuria appears at the end, it is mostly cystitis and prostate disease; if it is "whole course hematuria", the blood color is dark red, it is generally caused by kidney disease.

Second, when hematuria is found, we should first determine whether it is true hematuria, that is, exclude the false hematuria and red hematuria caused by some reasons. The former is caused by menstruation, hemorrhoid bleeding or bleeding near the urethral orifice mixed into the urine; the latter is caused by contact with some pigments or oral administration of rifampicin, some poisons (phenol, carbon monoxide, chloroform, snake venom), drugs (sulfanilamide, quinine), Hemoglobinuria or myoglobinuria caused by crush injury, burn, malaria and wrong blood transfusion. Transient hematuria can be caused by pollen, chemical substances or drug allergy. It can also occur during menstruation, after strenuous exercise and virus infection. Generally, it is not of great significance. Only when the above conditions are excluded and hematuria is detected for many times should we pay attention to it. Diagnosis should be made through medical history, physical examination, laboratory examination and other auxiliary examinations.

Third: after the determination of true hematuria, the location diagnosis of hematuria should be carried out to distinguish whether hematuria comes from renal parenchyma or urinary tract: ① if the tubular type is found in the urine sediment, especially the red blood cell tubular type, it means that the bleeding comes from renal parenchyma; ② hematuria with more serious proteinuria is almost the sign of glomerular hematuria; ② hematuria with more serious proteinuria is the sign of glomerular hematuria; ③ If we can find the tube type containing immunoglobulin in urine, it is mostly renal parenchymal hemorrhage; ④ hematuria caused by glomerular diseases, most of its red blood cells are abnormal, with different shapes and sizes, but not glomerular hematuria, most of its red blood cells are normal in size, only a few are abnormal red blood cells. The etiology of non glomerular hematuria is very complex. We should pay special attention to the malignant tumor of genitourinary system. The principle of symptomatic treatment of the two types of hematuria is opposite. Glomerular hematuria often needs anticoagulation, antithrombotic, antiplatelet aggregation or promoting blood circulation to remove blood stasis, while non glomerular hematuria often needs hemostasis.

matters needing attention

Shock is rarely seen in urine.