泌尿系统疾病 (2).ppt

泌尿系统疾病 World Kidney Day March 9th 2006 was the first WKD and then the second Thursday on march will be anniversary for kidney diseases. About 10% population involved Chronic Kidney disease (CKD) in USA About 100 million CKD in china ? of the total medical cost Introduction :background Effective management of the patient with renal disease is dependent upon establishing an accurate diagnosis. The clinician must be aware of the possible presentations of renal diseases and gather these symptoms and signs which form recognized diseases and syndrome What is the possible presentations suggesting renal problem ? Clinical presentation of renal disease The patient is asymptomatic, but an abnormality has been detected on clinical or laboratory examination which indicates an underlying renal disorder. The patient complains of a symptom or has a physical sign which directly or indirectly indicates underlying renal diseases The patient has a systemic disease which is known to be associated with renal involvement The patient has a family history of an inherited renal disorder. Symptoms of urinary tract disease A fever; dysuria; frequency; loinpain/abdominal pain; urinary inconsistency;offensive smelling;cloudy urine; Frothy urine :Proteinuria; Smokey urine : Haematuria Signs of urinary tract disease Dysmorphic syndromes; Anaemia; Oedema; High blood pressure; Renal masses; Distended bladder. Acute glomerulonephritis(AGN) 概述 病因 发病机制 病理生理 病理 临床表现 实验室检查 诊断 鉴别诊断 治疗 预后 目的要求 了解急性肾炎的病因及发病机理。 掌握一般病例与严重病例的临床表现及治疗原则。 掌握急性肾炎的实验室检查。 了解急性肾炎与其他病原体引起急性肾炎、慢性肾炎急性发作、特发性肾病综合症、IgA肾病综合症、急进性肾炎等疾病的鉴别诊断。 重点和难点 重点：本病的一般病例及严重病例的临床表现及其产生机理。 该病的尿液及血生化检查。 小儿单纯性血尿的诊断要点和处理原则。 难点：本症重症病例的治疗，高血压脑病急性肾功能不全，严重循环充血治疗及处理原则。 Acute poststreptococcal glomerulonephritis 急性链球菌感染后肾炎 Hematuria 血尿 Oliguria 尿少 Edema 浮肿 概 述 定义：急性起病，双侧性，弥漫性，前趋感染（非化脓性炎症），临床上以血尿为主，可有水肿、少尿、高血压，或