最后审阅: 30 十月 2021
最后更新: 23 六月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 排尿困难
  • 新发夜尿
  • 尿液浑浊
  • 危险因素
  • 发热

其他诊断因素

  • 尿急
  • 肉眼血尿
  • 尿频
  • 耻骨上疼痛或压痛
  • 胁腹痛
  • 肋脊角压痛
  • 新发失禁
  • 新发谵妄/虚弱,或者谵妄/虚弱恶化
  • 糖尿病失控
  • 不适感
  • 寒颤

危险因素

  • 性活动
  • 使用杀精剂
  • 绝经后
  • UTI 阳性家族史
  • 复发性 UTI 的病史
  • 有异物存在
  • 胰岛素治疗的糖尿病患者
  • 终生 UTI 发生率很高
  • 近期使用抗生素
  • 膀胱排空欠佳
  • 年龄增长

诊断性检查

首要检查

  • 尿试纸(试验)
  • 尿培养和药敏

需考虑的检查

  • 尿显微镜检查
  • 排泌后残余尿量
  • 肾脏超声
  • 腹部/盆腔 CT

治疗流程

撰稿人

专家顾问

Andrew Lewington,

Consultant Renal Physician

Honorary Associate Professor

Nephrology Department

Leeds Teaching Hospitals NHS Trust

Leeds

UK

利益声明

AL is Associate Clinical Director of NIHR Leeds In-Vitro Diagnostics Co-operative, Co-Chair of UK Kidney Research Consortium Renal Clinical Study Group, Member of Kidney Research UK Research Grant Committee, Committee Member of NICE Kidney Injury Clinical Guideline Update 2018-20, Committee Member of NICE Diagnostic Assessment for Point of Care Creatinine Testing 2018-19. AL attended the Acute Dialysis Quality Initiative Meeting in San Diego 2018 (accommodation expenses); AL was a speaker at the AKI & CRRT Conference in San Diego 2019 (travel and accommodation expenses), the AKI Conference in Coventry 2019 (travel expenses), and the NIHR AKI and Sepsis Meeting in Leeds 2019 (no expenses).

Acknowledgements,

BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:

Una J. Lee, MD

Female Pelvic Medicine and Reconstructive Surgery Section of Urology and Renal Transplantation

Virginia Mason Medical Center

Seattle

WA

利益声明

UJL declares that she has no competing interests.

同行评议者

Sheilagh Reid,

Consultant Urological Surgeon

Princess Royal Spinal Injuries Unit

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield

UK

利益声明

SR is lead for the spinal injuries urology course; in the past this course has received funding from Coloplast, AMS, and Hollister. SR is chair of the Female, Neurological, and Urodynamic Urology section of the British Association of Urological Surgeons.

编辑

Tessa Davis,

Section Editor, BMJ Best Practice

Consultant in Paediatric Emergency Medicine

Royal London Hospital

London

UK

利益声明

TD declares that she has no competing interests.

Emma Quigley,

Section Editor, BMJ Best Practice

利益声明

EQ declares that she has no competing interests.

Susan Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Rachel Wheeler,

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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