上课用泌尿外科症状及外科检查.pptx

泌尿外科症状及外科检查Symptoms Examinations of U.S.Department of Urinary SurgeryThe Second Affiliated Hospital of CQMU.CONTENT泌尿外科系统症状学Symptomatology of Urinary Surgery01泌尿外科系统检查Examination of Urinary System020201泌尿外科系统症状学PART ONESymptomatology of Urinary Surgery全身症状疼痛排尿改变尿液改变尿道分泌物男性性功能障碍1. 全身症状女性最多见于急性肾盂肾炎；男性最多见于急性前列腺炎、急性附睾炎。发热和寒战是任何部位的泌尿生殖道感染最常见的全身症状。Department of Urinary Surgery, the Second Affiliated Hospital of CQMU042. 疼痛输尿管痛：肾绞痛由肾盂输尿管连接处或输尿管急性梗阻、 输尿管扩张引起，表现为急性发作，阵发性绞痛，剧烈难忍，伴恶心、呕吐，向输尿管行径及睾丸或阴唇放射。肾脏疼痛：多为肋脊角持续性钝痛，可绕过腰部放射至上腹部和肚脐，也可放射至会阴和睾丸。前列腺痛：继于前列腺炎症所致的组织水肿或被膜扩张，疼痛不能准确定位，多诉会阴部、下腹部、腹股沟区、腰骶部或直肠内疼痛，多伴有排尿刺激症状，如尿频或尿痛。膀胱痛：多为急性尿潴留致膀胱过度充盈所致，膀胱炎时可出现间歇性耻骨上区疼痛，疼痛为锐痛、烧灼痛，男性常放射至尿道远端，女性则放射至整个尿道。阴囊痛：可分为原发性（如附睾炎、睾丸或附睾附属物扭转及外伤等）和继发于肾绞痛及前列腺炎症所引起的放射痛。阴茎痛：非勃起，由膀胱或尿道炎症引起，使尿道口最明显的放射痛；包皮嵌顿。阴茎异常勃起。Department of Urinary Surgery, the Second Affiliated Hospital of CQMU053. 排尿改变尿潴留漏尿梗阻症状尿路刺激症排尿改变尿失禁遗尿Department of Urinary Surgery, the Second Affiliated Hospital of CQMU063. 排尿改变尿频由泌尿、生殖道炎症，膀胱结石或肿瘤、前列腺增生等原因造成膀胱有效容量减少或排空障碍所致。也可为饮水过多、糖尿病、尿崩症、原发性醛固酮增多症引起。尿路刺激症状尿痛尿急疼痛呈烧灼感，与膀胱、尿道或前列腺感染有关。排尿开始时出现说明病变在尿道，在终末时说明病变可能在膀胱。 继发于膀胱炎症、膀胱容量过小，顺应性降低时；亦可见于焦虑病人。Department of Urinary Surgery, the Second Affiliated Hospital of CQMU073. 排尿改变排尿困难：由膀胱以下尿路梗阻引起，包括排尿踌躇、尿不尽、费力感、尿线无力、分叉、滴沥等。尿流中断：由膀胱结石在膀胱颈形成活塞，阻断排尿过程而引起。梗阻症状Department of Urinary Surgery, the Second Affiliated Hospital of CQMU083. 排尿改变急性尿潴留见于膀胱以下严重尿路梗阻，突然不能排尿，患者痛苦，耻骨上区疼痛，且可触及充盈膀胱。慢性尿潴留长期排尿困难缓慢发展的结果，多无疼痛感觉。Department of Urinary Surgery, the Second Affiliated Hospital of CQMU093. 排尿改变Department of Urinary Surgery, the Second Affiliated Hospital of CQMU103. 排尿改变漏尿 ——绕过尿道括约肌由瘘口流出。遗尿——睡眠中无意识地排尿。Department of Urinary Surgery, the Second Affiliated Hospital of CQMU114. 尿液改变——尿量3000-5000ml/24h1000-2000ml/24h400ml/24h200ml/24h0ml/24hDepartment of Urinary Surgery, the Second Affiliated Hospital of CQMU124. 尿液改变——尿的观察Department of Urinary Surgery, the Second Affiliated Hospital of CQMU134. 尿液改变——尿的观察Department of Urinary Surgery, the Second Affiliated Hospital of CQMU144. 尿液