小洋 asked in 社會與文化語言 · 1 decade ago

專業醫學~麻煩高手解答翻譯

A thorough evaluation of the urinary system may fail to identify a source of microscopic hematuria. In studies in which both imaging of the upper urinary tract and cystoscopy were performed in patients with microscopic hematuria, a source was not identified in 19 to 68 percent of the patients evaluated.

Microscopy was not routinely part of the evaluation in these studies, suggesting that more glomerular causes of microscopic hematuria might

be identified with this addition.

Follow-up of patients with unexplained microscopic hematuria has been evaluated in two studies, both without a control group. In one, 191 patients with asymptomatic hematuria that remained unexplained

after urologic evaluation with urinalysis, cytologic analysis of voided urine, excretory urography, and cystoscopy subsequently underwent excretory urography and cystoscopy. No cancers were detected during follow-up, prompting the authors to suggest that no further studies are necessary unless symptoms develop.

This suggestion was corroborated by similar recommendations in another

prospective study.

Currently, the data are inadequate to support clearcut recommendations regarding the evaluation and management of microscopic hematuria. Shortcomings of available studies include inconsistencies in definition, study design, selection criteria, and diagnostic-test techniques and procedures used.

Data are lacking on outcomes in patients with microscopic hematuria who did not undergo formal evaluation and those in whom the finding remained unexplained despite evaluation. In addition, there have been no randomized trials comparing the outcomes associated with different strategies.

The U.S. Preventive Services Task Force and the Canadian Task Force on the Periodic Health Examination do not recommend routine screening of urine for microscopic hematuria.

1 Answer

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  • 1 decade ago
    Best Answer

    即使是做了徹底的泌尿系統檢查,仍然有可能找不出顯微性血尿的原因,有一個研究讓有顯微性血尿的病人接受了膀胱鏡和上泌尿道的影像學檢查,但是有19到68%的病人無法確定病因,顯微鏡檢查不是這些研究中的常規檢查項目之一,我們假設有更多因腎絲球疾病引起的顯微性血尿可被顯微鏡檢篩檢出來。

    有顯微性血尿但卻查不出原因的病人在兩個研究中做了後續的評估,但兩個研究都沒有對照組,其中一個搜集了191個做了泌尿道評估(包括尿液分析、尿液細胞學鏡檢、IVP和膀胱鏡檢查)但卻找不出病因的無症狀血尿病人,讓他們再做一次IVP和膀胱鏡檢查,結果並沒有發現任何癌症的病例,所以研究者做的結論是,除非有症狀產生,否則不需要替病人做下一步的檢查,這個假設被另一個預期有類似結果的研究證實了。

    目前這些資料並沒有充分到可以明白的指出顯微性血尿該如何評估和處理,其缺點在於這些研究資料的定義矛盾而不夠清楚,研究的設計、診斷標準的準則、診斷測試的技術和步驟都還有改善的空間(這句真的只是翻大意,就是上述的東西都決定的不夠嚴謹,使得研究資料的可信度受到質疑。)

    研究資料對於那些有顯微性血尿但卻沒有做過前述那些檢查,以及檢查過卻仍然找不出原因的病人,並沒有明確的指出他們的預後結果,此外,並沒有不同時期(應是疾病嚴重度不同)血尿病人的隨機試驗來和這些研究的結果做比較。

    美國Preventive Services Task Force和加拿大Task Force on the Periodic Health Examination(兩個協會的名稱,我沒聽過還是不要亂照字面翻的好…)都不建議為了血尿做常規性的篩檢動作。

    呵呵~~最後一篇囉~~

    如果我翻的文章有幫到你的忙,我也會覺得很開心

    希望我翻的文章你會滿意呢^^

    Source(s): 本人在下~~~
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