Abstract:
Comprehensive urinalysis involves inspection of the urine, dipstick chemical analysis, and microscopy and can be performed in the office setting. When testing for urinary tract infection, midstream urine should be collected using the clean-catch technique. A urine collection bag specimen can be used for clinically stable febrile infants with suspected urinary tract infection; however, the presence of leukocyte esterase or nitrites warrants more invasive urine collection. Urine specific gravity shows hydration status. Urinary pH levels can indicate diet, metabolism, or the presence of stones. Bilirubin and urobilinogen may suggest hepatobiliary disease or hemolysis. Glucosuria often indicates uncontrolled diabetes mellitus, and ketones suggest illness and inadequate nutrition. Hematuria on dipstick testing can be confirmed in the office using a spun urine sample. Proteinuria on dipstick testing should be followed by a quantitative test such as a spot urine albumin/creatinine ratio. In patients with symptoms of a urinary tract infection, the presence of nitrites is more specific for bacterial infection, and a positive leukocyte esterase result may occur from inflammation and infection. Asymptomatic bacteriuria is often unnecessarily treated in older patients. Without symptoms of urinary tract infection, urine culture is useful only in pregnancy and preparation for endoscopic urologic procedures.
摘要:
全面的尿液分析包括尿液检查,试纸化学分析,和显微镜,可以在办公室设置进行。当检测尿路感染时,应使用清洁捕获技术收集中游尿液。尿液收集袋标本可用于临床稳定的发热婴儿,怀疑有尿路感染;然而,白细胞酯酶或亚硝酸盐的存在需要更多的侵入性尿液收集。尿比重显示水合状态。尿液pH值可以指示饮食,新陈代谢,或者石头的存在。胆红素和尿胆红素原可能提示肝胆疾病或溶血。糖尿通常表明不受控制的糖尿病,和酮表明疾病和营养不足。试纸测试中的血尿可以在办公室使用尿液样本进行确认。试纸测试中的蛋白尿应进行定量测试,例如斑点尿白蛋白/肌酐比率。在有尿路感染症状的患者中,亚硝酸盐的存在对细菌感染更有特异性,白细胞酯酶阳性结果可能是由炎症和感染引起的。在老年患者中,无症状的菌尿通常是不必要的治疗。没有尿路感染的症状,尿培养仅在妊娠和准备内窥镜泌尿外科手术中有用。