尿液分析课件Urinalysis.pptVIP

Urinalysis Urinary System Purpose ? General evaluation of health ? Diagnosis of disease or disorders of the kidneys or urinary tract ? Diagnosis of other systemic disease that affect kidney function ? Monitoring of patients with diabetes ? Screening for drug abuse (eg. Sulfonamide or aminoglycosides) Collection of urine specimens ? The first voided morning urine (the most common) ? Random urine (for emergency) ? Clean-catch, midstream urine (for urine culture) Attention ? Need to be examined within 1 hour Contents ? Physical examination ? Chemical examination ? Microscopic examination Physical examination ? Appearance ? Urine volume ? Specific gravity (SG) Appearance ? Including color and clarity ? Color : normally , pale to dark yellow (urochrome) Abnormal color : some drugs cause color changes 1. red urine : causes: hematuria hemoglobinuria myoglobinuria 2. yellow-brown or green-brown urine : bilirubin cause : obstructive jaundice Red Urine ? Microscopic Hematuria ? Urinary tract source ? Urethra or bladder ? Prostate ? Ureter or kidney ? Non-Urinary tract source ? Vagina ? Anus or rectum ? Pseudohematuria (non- hematuria related red urine) ? Myoglobinuria ? Hemoglobinuria ? Phenolphthalein Laxative s ? Phenothiazines ? Porphyria ? Rifampin ? Pyridium ? Bilirubin uria ? Phenytoin ? Pyridium ? Red diaper syndrome ? Foods (Beets, Blackberries, Rhubarb) Red Urine ? Causes of Asymptomatic Gross Hematuria by Incidence ? Acute Cystitis (23%) ? Bladder Cancer (17%) ? Benign Prostatic Hyperplasia (12%) ? Nephrolithiasis (10%) ? Benign essential hematuria (10%) ? Prostatitis (9%) ? Renal cancer (6%) ? Pyelonephritis (4%) ? Prostate Cancer (3%) ? Urethral stricture (2%) Appearance ? Clarity : normally, clear Abnormal color : cloudy urine Causes: 1. crystals or nonpathologic salts phosphate, carbonate in alkaline urine (dissolve---add acetic acid) uric acid in acid urine (dissolve---warming to 60 ℃ ) 2. various cellular elements: l