内科学尿路感染(英文).ppt

Laboratory examinations Urinary routine White cells are frequently observed. Detection of leukocyte casts is also an indication of involvement of the kidney. hematuira Proteinuria, 2g/d, low molecular protein. Low gravity, high pH, when the tubular dysfunction occurs. .尿十项指标的英文缩写： GLU 葡萄糖 BIL 胆红素 KET 酮体 SG 比重 PH 酸碱度 PRO 蛋白质 UBG 尿胆原 NIT 亚硝酸盐 BLD(ERY) 红细胞 LEU 白细胞 Negative 阴性 Positive 阳性 Trace 微量 * 超过正常 Moderate 中等量 Large 大量 Laboratory examinations Gram’s stain The simplest method for detecting significant bacteriuria is to examine the urine under the microscope, using Gram’s stain. If bacteria are found using the oil immersion objective, there are likely to be more than 105 bacteria/ml of urine. Laboratory examinations clean mid-stream urine culture The most widely used method of collecting urine for culture and is the method of choice. If the bacterial counts 100000/ml, can be defined significant result. When bacterial count 10000/ml, can be regard as contaminated. Coccus count reaches 1000~10000/ml also can be defined significant result. Clean mid-stream urine culture, notice: the procedure should be done before antibiotic therapy or 5 days after cessation antibiotic therapy. the first uriation is preferred for the bacteria can grow more. strict attention to asepsis is necessary. Other examinations Blood routine test: WBC?，ESR ? ，CRP ? Antibody-coated bacteria: help to distinguish pyelonephritis from the lower UTI Renal function tests: defect in urinary concentrating, acidification capacity as well as glomerular filtration function. Radiologic evaluations Radiologic evaluations objective: delineate abnormalities that would lead to changes in the medical or surgical mangement of the patient. Indication: recurrence; complicated UTI; clinical presentation of pyelonephritis; rare pathogen infection; persistent infection; male Notice: should be avoided