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この女性は,急性無合併症の尿路感染症を患っているのでしょうか?
Stephen Bent1, Brahmajee K Nallamothu, David L Simel
1University of California, San Francisco, San Francisco VAMC, 94121, USA. bent@itsa.ucsf.edu
JAMA
|May 22, 2002
まとめ
女性における尿路感染症 (UTI) の臨床評価は不確実である. 特定の症状の組み合わせによって尿路感染症の診断が可能ですが,病歴や検査のみに基づいて感染を排除することは信頼できません.
科学分野:
- 泌尿器科 泌尿器科とは
- 感染症 感染症は感染症です.
- クリニカル診断士
背景:
- 尿路感染症 (UTI) の症状は,女性の診療所訪問の一般的な理由です.
- 尿路感染症の臨床評価の診断的正確性は依然として不確実である.
- 病歴と身体検査は標準的な診断要素です.
研究 の 目的:
- 女性における尿路感染症の診断の正確性と正確な履歴と身体検査の精度を評価する.
- 急性非合併症性尿路炎の診断における臨床評価の信頼性を評価する.
- 特定の症状や徴候が尿路感染症を予測する効果を判断する.
主な方法:
- 広範な文献検索を実施しました (MEDLINE,資料集,教科書,専門家の連絡先).
- 女性におけるUTI診断の履歴/身体検査の精度に関するオリジナルのデータを含む研究.
- 審査対象は,464件の研究で,9件の含有基準を満たしており,データは独立して抽象化されています.
主要な成果:
- ディスウリア,頻度,出血,背中の痛み,CVAの痛みは,尿道感染症の確率を高めました.
- 消尿症/腰痛の欠如,および陰道下水の歴史/存在は,尿路感染症の確率を低下させた.
- 症状の組み合わせ (ジスウリア,発症頻度,陰道症状の欠如) は,尿路感染症の確率 (>90%),自己診断の確率も著しく増加した.
結論:
- 尿路感染症の症状を持つ女性の約50%が感染しています.
- 特定の症状のクラスターは,単に病歴に基づいて,尿路感染症を効果的に診断することができます.
- 病歴,身体検査,尿検査は,症状があるときに尿路感染症を確実に排除するには不十分です.
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