“血尿”“三问十二字”临床教学思路探讨

血尿是肾病科常见的临床表现,对于血尿的病因诊断分析在临床中不容易掌握,有漏诊的风险,因此需要系统而全面的诊断思路。我科在临床教学中总结了"三问十二字"的教学思路,收到较好的效果。三问包括第一问尿液呈现红色是否为血尿?第二问为符合血尿是否为病理状态?第三问为血尿一定是否只有肾脏疾病?通过三问来明确血尿的定义,并逐渐剖析临床非血尿、真性血尿、假性血尿、内科性血尿以及外科性血尿的意义。再通过内科性血尿的特点高度概括出"十二个字",以帮助学生区分内科性血尿及外科性血尿。通过"三问十二字"的深入浅出学习,可以将血尿复杂的诊断思路由繁入简掌握,并实践于临床。

Discussion on Clinical Teaching Ideas of Hematuria by"Three Questions and Six Words"

Hematuria is a common clinical manifestation in nephrology department.The etiological and analysis of hematuria is not easy to grasp in clinic,and there is a risk of missed diagnosis.Therefore,a systematic and comprehensive diagnostic approach is needed.In clinical teaching,our department summarized ideas called"three questions and six words"and achieved good results.Three questions include the first question:Is red urine hematuria?The second question is whether hematuria is pathological?The third question is whether hematuria must be a kidney disease only?Through three questions to clarify the definition of hematuria,and gradually analyze the clinical significance of non-hematuria,true hematuria,pseudohematuria.Through the characteristics of hematuria due to kidney disease,we can summarize"six words"to help students distinguish between kidney disease and surgical diease.Through the in-depth study of"three questions and six words",the complicated diagnostic thinking of hematuria can be easily grasped and applied to clinical practice.