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这位女性是否患有急性无并发性尿路感染?
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
概括
对女性尿路感染 (UTI) 的临床评估是不确定的. 特定的症状组合可以诊断尿路感染,但仅根据病史或检查排除感染是不可靠的.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 尿路感染 (UTI) 症状是女性去诊所的常见原因.
- 对于尿路感染的临床评估的诊断准确性仍然不确定.
- 病史和体检是标准的诊断组成部分.
研究的目的:
- 审查女性尿路感染病史和体检的诊断准确性和精确性.
- 评估临床评估在诊断急性无并发性尿路感染时的可靠性.
- 确定特定症状和迹象在预测尿路感染方面的有效性.
主要方法:
- 进行了全面的文献搜索 (MEDLINE,书目,教科书,专家联系).
- 包括使用原始数据对女性尿路感染诊断史/体检准确度的研究.
- 选了464项研究,其中9项符合纳入标准;数据独立抽象.
主要成果:
- 尿失调,频率,出血,背部疼痛和CVA疼痛增加了尿路感染的可能性.
- 缺失尿尿症/背痛,有阴道泄漏史/存在阴道泄漏,降低了尿路感染的可能性.
- 症状组合 (尿,频率,无阴道症状) 显著增加了尿路感染的概率 (>90%);自我诊断也增加了概率.
结论:
- 大约50%的患有尿路感染症状的女性患有感染.
- 特定的症状集群可以有效地根据病史单独诊断尿路感染.
- 病史,体检和尿检不足以在症状出现时可靠地排除尿路感染.
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