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1、尿液常規(guī)檢查generalexaminationofurineBasicexaminationofurineComponent:specimenevaluationgross/physicalexaminationchemicalscreeningsedimentexamination尿液標(biāo)本的種類kindsofurinespecimens1.首次晨尿2.隨機(jī)尿3.餐后尿4.定時(shí)尿尿液的理學(xué)檢查urinephysicalexamination:尿量volume顏色colour氣味odour尿液試紙條ur
2、inaryreagentstripStripItisaplasticstriponwhichareattachedaseriesofchemicallyimpregnatedabsorbentpads.Eachpadcontainscertainchemicalsthatreactwithasubstanceintheurine,producingacolorchangeinthepad.MostoftheavailablestripscontainpadsfordeterminationofPH,he
3、moglobin,glucose,protein,urinaryketones,bilirubin,urobilinogen,nitrites,specificgravityandleukocyteesterase.尿液分析試紙項(xiàng)目縮寫符號(hào)反應(yīng)原理酸堿度pHpH指示劑蛋白質(zhì)PROpH指示劑的蛋白質(zhì)誤差法葡萄糖GLU葡萄糖氧化酶法隱血BLD血紅蛋白類過氧化物酶法膽紅素BIL偶氮反應(yīng)法尿膽原URO醛反應(yīng)法、重氮反應(yīng)法酮體KET硝基鐵氰化鈉法亞硝酸NIT重氮鹽法白細(xì)胞LEU酯酶法比密d(SG)多聚電解質(zhì)離子解
4、離法抗壞血酸ASG吲哚酚法尿亞硝酸鹽尿路感染的病原微生物種類體內(nèi)適量硝酸鹽的存在尿液標(biāo)本留取的時(shí)間藥物的影響菌尿癥常見微生物及致病率分類菌名致病率(%)含硝酸鹽還原酶大腸桿菌屬Klebs氏桿菌屬變形桿菌葡萄球菌屬假單胞菌屬72.016.05.05.01.0不含硝酸鹽還原酶糞鏈球菌屬1.0一、尿標(biāo)本制備prepareofurinespecimen:離心centrifugation低倍鏡下:全片觀察,計(jì)數(shù)管型(20個(gè)視野)高倍鏡下:細(xì)胞計(jì)數(shù)、復(fù)查管型、結(jié)晶(10個(gè)視野)二.尿細(xì)胞成分檢查及臨床意義urina
5、rycellelementexaminationandclinicsignificance(一)紅細(xì)胞redcell參考值referenceinterval:混勻一滴尿0~偶見/高倍視野離心尿0~3個(gè)/高倍視野1.量quantity肉眼血尿:如果每100ml尿液中含有0.1ml以上的血液時(shí),肉眼能看到不同程度的渾濁紅色,稱為肉眼血尿。Visualhematuria:Excretionofurinecontainingblood,whichcanbedemonstratedbyeyes.UsuallyR
6、BCsaremorethan50/HPFbythemicroscope.顯微鏡血尿microscopichematuria:100ml尿液中含有0.1ml以下的血液,肉眼看不見,只有通過顯微鏡才能發(fā)現(xiàn),稱顯微鏡血尿。Microscopichematuria:Excretionofurinecontainingblood,whichcanbedemonstratedonlybythemicroscopeandusuallyequalormorethan3/HPF.2.形態(tài)form(質(zhì)quality)新鮮尿
7、中紅細(xì)胞形態(tài)對(duì)鑒別腎小球源性和非腎小球源性血尿有重要價(jià)值。異形紅細(xì)胞>30%肯定診斷為腎小球性;15%~30%初步診斷;<15%肯定診斷為非腎小球性。4.臨床意義clinicsignificance生理:劇烈運(yùn)動(dòng),冷水浴,久站,重體力勞動(dòng)后可出現(xiàn)暫時(shí)性鏡下血尿。病理:(1)泌尿系統(tǒng)自身疾?。海?)全身其他系統(tǒng)的疾病:(3)泌尿系統(tǒng)附近器官的疾?。喊准?xì)胞whitecell鏡下膿尿microscopicpyuria:如果鏡下白細(xì)胞大于5個(gè)/Hp為增多。Microscopicpyuria:Theproduc
8、tionofurinethatcontainswhitebloodcells,wheninspectedbythemicroscope.Exampleswhichmayresultinpyuriaincludeurinarytractinfection,tuberculosis,cancerandacutepyelonephritis.膿細(xì)胞puscell:炎癥時(shí)白細(xì)胞發(fā)生變異或已死亡,其外形變得不規(guī)則,結(jié)構(gòu)不清,稱為膿細(xì)胞,其往往成團(tuán)分布