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 <\/p>\n

https:\/\/video3.mingpao.com\/201606\/HET20160623_01.mp4\u5c0f\u4fbf\u6709\u8840 \u7559\u610f\u6709\u7121\u75db;https:\/\/video3.mingpao.com\/201606\/HET20160623_02.mp4\u8840\u5c3f\u5982\u4f55\u8a3a\u65b7\u6700\u6e96\u78ba;https:\/\/video3.mingpao.com\/201606\/HET20160623_04.mp4\u62bd\u7d44\u7e54\u6aa2\u67e5\u6e96\u78ba\u5ea6\u9ad8;https:\/\/video3.mingpao.com\/201606\/HET20160623_05.mp4\u8180\u80f1\u93e1 \u816b\u7624\u7121\u6240\u9041\u5f62;https:\/\/video3.mingpao.com\/201606\/HET20160623_06.mp4\u679c\u6c41\u51b0\u51b0;https:\/\/health2.mingpao.com\/ftp\/Health2\/20160711\/news\/_11ya101.jpg;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】尿尿後，駭然發現廁盆染紅，大吃一跳。<\/p>\n

血尿常見於40至80歲人士，同一徵狀，不同年齡病情大不同。年輕人血尿，大都是泌尿道結石引起，老年和煙民，就要擔心癌症來襲。<\/p>\n

血尿，可以是內科，即腎科的疾病，亦可能是外科，即泌尿外科的問題。血尿究竟有何病因？如何分科？<\/p>\n

血尿未必看得見？<\/p>\n

「肉眼看不見的血尿，只是透過驗尿時發現紅血球，大多數是內科問題，轉介腎科跟進。」屯門醫院泌尿外科部副顧問醫生楊協和舉例指出，顯微鏡或試紙才能測出的血尿，可能是腎小球出現隙縫穿孔，導致紅血球泄漏。<\/p>\n

至於看得見的血尿，多數是泌尿外科疾病，問題可能是出於腎臟、輸尿管、膀胱、前列腺，甚至是尿管。<\/p>\n

◆腎臟﹕結石、腫瘤、炎症<\/p>\n

◆膀胱﹕結石、腫瘤、炎症<\/p>\n

◆前列腺﹕前列腺肥大、炎症、腫瘤<\/p>\n

◆尿管﹕結石、腫瘤<\/p>\n

「血尿伴隨痛楚，很大可能是結石，所以病人要留意自己有沒有出現痛楚，以及哪一個位置出現痛楚。」楊協和提醒，結石、腎腫瘤可發生在男或女性身上；另外，男士獨有的前列腺問題，女士常見的尿道炎，都可能導致血尿。<\/p>\n

不同階段的血尿，能否反映不同疾病？<\/p>\n

「小便前、中段帶血，多是前尿路問題，而中、後段有血，偏向是腎或前列腺的問題。」然而，楊協和指出，究竟是前、中、後段出現血尿，其實不容易判斷，所以不能作準。<\/p>\n

顏色深淺未必反映病况<\/p>\n

另外，可否從血尿顏色的深淺，判斷病情嚴重性？<\/p>\n

「血色濃淡未必能反映病情嚴重性，舉例說，結石割損尿道，可能會流很多血；而惡性腫瘤可能只是一小處流血。」<\/p>\n

一旦懷疑是腫瘤，視乎不同位置進行不同檢查。腎腫瘤可以透過電腦掃描或腎穿刺確診。楊醫生指出，抽取腎組織，透過皮外穿刺，從背部插針入腎臟抽取組織化驗。若懷疑是膀胱癌，就要由尿道伸入膀胱鏡做檢查，膀胱鏡可以由尿道上至膀胱，有些甚至可以上至輸尿管及腎盂，利用內窺鏡觀察有沒有異常組織。<\/p>\n

不幸確診膀胱癌，如非入侵性，只需將腫瘤刮除。楊醫生表示，若屬入侵肌肉性膀胱腫瘤，就要將膀胱切除，然後利用一截小腸充當人造膀胱，接駁輸尿管和尿道。<\/p>\n

文：鄭寶華、陳雅君<\/p>\n

圖：黃志東、Giorez、Janeness@iStockphoto<\/p>\n

編輯：王翠麗<\/p>\n

■有片睇<\/p>\n

想現場直擊家庭醫生睇醫生，可登入 www.mingpaohealth.com\/doc.htm<\/a><\/p>\n

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