多器官功能障碍综合征MODS.docVIP

《外科学》 Copyright ? 西安交通大学医学院第一附属医院泌尿外科 邢俊平 来源：西安交通大学医学院医学论坛[/bbs/]-[学生园地]-[2002级临硕一系]专版 Seadoctor制作 第 PAGE 57 页 泌尿外科疾病的诊断方法 泌尿外科的学科范畴 第一节 主要症状 ㈠全身症状 (Systemic symptoms) 1. 1 Fever The presence of fever associated with other symptoms of urinary tract infection may be helpful in evaluating the site of the infection. For example: Simple acute cystitis is essentially an afebrile disease. Acute pyelonephritis or protatitis is apt to cause high temperatures (to 40℃), and often accompanied by violent chills. Infants and children suffering from acute pyelonephritis may have high temperatures without other localizing sympyoms or signs. A history of unexplained attacks of fever occurring even years before may represent otherwise asymptomatic pyelonephritis. Renal carcinoma sometimes causes fever that may reach 39℃ or more. 1.2 Weight loss It is to be expected in the advanced stage of cancer, but it may be noticed also when renal insufficiency duo to obstruction or infection supervenes. In children who have “failure to thrive” (low weight and less than average height for age), chronic obstruction, urinary tract infection, or both should be suspected. 1.3 General malaise It may be noted with tumors, chronic pyelonephritis, or renal failure 1.4 gastrointestinal symptoms of urologic  diseases whether renal or ureteral disease is painful or not, gastrointestinal symptoms - severe nausia and vomiting as well as abdominal distention are often present. The patient with acute pyelonephritis suffers not only from localized back pain, symptoms of vesical irritability, chills and fever but also from generalized abdominal pain and distention. ㈡局部症状 （Local symptoms） 1、疼痛（pain） ⑵疼痛的机制 空腔脏器：内压升高、扩张、平滑肌痉挛 实质脏器：包膜的张力增加 ⑶泌尿系各器官的疼痛特点 肾疼痛 输尿管疼痛 膀胱疼痛 前列腺疼痛 2、排尿异常 ⑴膀胱刺激症状 ⑵排尿困难： 膀胱内尿液排出受阻引起的一系列症状 排尿踌躇：排尿开始时间延迟 排尿费力：用增加腹内压以启动排