Hematuria refers to the abnormal increase of red blood cell excretion in urine, which is a signal that there may be serious diseases in the urinary system. Hematuria is defined as abnormal increase of red blood cells in urine, centrifugal precipitation with urine field of vision ≥3 red blood cells per high magnification, or non-centrifugal urine exceeding 65,438+0 or 65,438+0 hours, urine red blood cell count exceeding 654,38+0 million, or urine sediment count exceeding 500,000 hours. In mild cases, only erythrocytosis is found under the microscope, which is called hematuria under the microscope; In severe cases, the appearance is watery or contains blood clots, which is called gross hematuria. Usually, when there is 1 ml of blood in every liter of urine, it can be seen by naked eyes, and the urine is red or has a meat washing water sample.
[Causes of hematuria]
More than 95% hematuria is caused by diseases of the urinary system itself, including glomerular diseases (acute nephritis, acute nephritis, membranous proliferative nephritis, mesangial proliferative nephritis, focal glomerulosclerosis, etc. ), renal cyst, calculus (kidney, ureter, bladder, urethral calculus), prostatic hyperplasia, urinary tract infectious diseases (tuberculosis, pyelonephritis, seminal vesiculitis, prostatitis), tumor (prostatitis). Other diseases such as abnormal coagulation (idiopathic or drug-induced thrombocytopenia, hemophilia, scurvy, etc. ) and systemic diseases (aplastic anemia, leukemia, systemic lupus erythematosus, dermatomyositis, leptospirosis, epidemic hemorrhagic fever, etc. ) can also cause hematuria.
Blood in urine is hematuria, also called hematuria.
Under normal circumstances, there are no red blood cells in urine. After the patient's urine is centrifugally precipitated in medicine, it is examined by microscope. If there are more than 5 red blood cells in each high-powered field, it is called hematuria. If only red blood cells are detected under the microscope, but the eyes can't see the urine with blood, it is called hematuria under the microscope; If the eyes can see that the urine is "watery" or bloody, or even there are bloodshot or blood clots in the urine, it is called gross hematuria. So hematuria is not always found with the naked eye. You can see blood in the urine with your eyes. About 1000 ml of urine is mixed with at least 1 ml of blood, indicating that hematuria is serious, so we should find out the cause and treat it actively.
(A) the cause of hematuria
Hematuria is often caused by diseases of urinary organs. Human urine is produced in the kidney and excreted through the renal pelvis, ureter, bladder and urethra. Any disease and bleeding of these organs will cause hematuria.
Common diseases that cause hematuria include nephritis, urinary system infection, hemorrhagic cystitis, urinary calculi, renal tuberculosis, renal tumor, renal and urethral injury, etc. Hematuria is one of the main symptoms of these diseases.
(2) Differential diagnosis of hematuria
When micturition begins with hematuria and the urine in the latter part is normal, it is generally a urethral disease; If micturition begins to be normal, hematuria will eventually appear, mostly cystitis and prostate disease; If it is "total hematuria", the blood color is dark red, which is generally caused by kidney disease. Urinating blood rarely shows shock.
Hematuria is common in the following diseases:
1? One week before the onset of acute glomerulonephritis hematuria with oliguria, proteinuria, edema, hypertension and tonsillitis.
2? Pyelonephritis, hematuria with dysuria, urgency, frequent urination, low back pain and fever.
3? Urinary calculi are characterized by hematuria with renal colic, or with symptoms such as interruption of urination, dysuria and dysuria.
4? More than 90% of patients with renal tuberculosis have hematuria, which is characterized by urgency, frequent urination and dysuria.
5? Kidney and urinary tract injuries often have a history of waist or abdomen injuries, such as contusion, collision and fall.
6? Henoch-Schonlein purpura is a disease with bleeding spots, gastrointestinal bleeding and joint pain. Hematuria appears 2 ~ 4 weeks after the skin has bleeding spots.
7? Systemic diseases such as vitamin C and vitamin K deficiency, and hematological diseases such as leukemia and hemophilia can all cause hematuria.
8? Drug-induced hematuria Some drugs are harmful to the kidneys and can cause hematuria after taking them. Such as gentamicin, tetracycline, sulfonamides, kanamycin, etc.
9? Temporary hematuria is caused by drinking too little water, and it will disappear quickly after increasing the amount of drinking water and diluting urine.
(3) Rescue measures
(1) Stay in bed and minimize strenuous activities. If necessary, you can take phenobarbital, diazepam and other sedative sleeping pills.
(2) Drink plenty of water to reduce the crystallization of salt in urine and accelerate the excretion of drugs and stones. People with nephritis and edema should drink less water.
(3) Use hemostatic drugs, such as Anluoxue, Zhixuemin, vitamin K, vitamin C, etc.
(4) Use drugs that cause hematuria with caution, especially those with existing kidney diseases.
(5) Hematuria is caused by urinary tract infection. Antibiotics and urinary tract cleaners, such as norfloxacin, furacilin, ampicillin, penicillin, metronidazole, etc., can be taken orally or injected.
(6) Urinary stones often have severe abdominal pain, and belladonna tablets and 654 can be taken orally. 2. Atropine relieves spasm and pain.
(7) The cause of hematuria is complicated, and some cases are very serious. We should go to the hospital as soon as possible for diagnosis and thorough treatment. Unilateral nephrectomy is feasible after the diagnosis of renal tuberculosis and renal tumor, so as to achieve the goal of radical cure.
Treatment (TCM):
Traditional Chinese Medicine Prescription (1)
[Fang Ming] Zhang Bing San.
[Composition] 30-60g of cogongrass rhizome (denuded), 3-6g of ginger and 30g of honey.
[Usage] Decoct the first two herbs in water to get juice, then pour it into honey, one dose a day, and take it three times.
[Note] None.
[Chuchu] Collection of secret recipes for health care and treatment.
Attachment: Gynecological Menstrual Hematuria Prescription
(1) simple square selection
① Rhizoma Imperatae 30g, Folium Pyrrosiae 15g, Cirsium japonicum 15g, decocted in water (suitable for hematuria caused by blood heat).
(2) 3 grams of carbonized blood and 3 grams of fried gardenia charcoal. * * * Grind into fine powder and take it twice (all types of hematuria can be used).
③ Radix Rehmanniae 15g, Rhizoma Imperatae 30g and Radix Rubiae 12g. Decoct in water (suitable for those with yin deficiency and excessive fire in blood in urine).
④ 9 grams of calcined ophicalcitum and 6 grams of notoginseng. * * * Grind into fine powder and take it in three times (suitable for patients with blood stasis and internal resistance).
(2) Diet therapy
(1) fresh ground 60 grams, rice 100 grams. Cook porridge to eat (suitable for people with yin deficiency and fire flourishing)?
② Thistle 50g. Make soup to eat (it is suitable for all types of hematuria).
③ cogongrass rhizome 30g, rock sugar 10g. Drink water instead of tea.
④ Astragalus membranaceus 30g, ginseng 15g, raw chicken 1 chicken. Cooked and eaten (suitable for people with spleen deficiency).
⑤ Eupatorium adenophorum and green tea 10g each. Replace tea with water (suitable for those with blood stasis and internal resistance).