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상품상세정보 / 관련상품목록 / 상품구매후기 / 상품Q&A
책소개
머 리 말
임상에서 요의 물리적 및 화학적 검사와 요침사의 현미경적 검사는 임상병리검사 분야에서
가장 기본적인 검사로 특수한 장비 없이도 시행할 수 있고, 환자에게 고통을 주지 않으며 단시
간 내 결과를 얻을 수 있는 특성으로 각종 질환의 조기 진단에 유용하게 이용되므로 요검사학
은 임상병리학에서 기초학문으로 필수과목이다.
최근 의료환경과 병원에서의 검사방법 및 의료장비가 하루가 다르게 급속도로 발전하고 있
고, 산업체의 기술력 발달로 다양화, 세분화, 전문화됨에 따라 임상병리사의 높은 기술능력이
요구되는 것은 바람직한 현상이다. 이에 따라 대학에서도 현장에 적응할 수 있는 기술능력을
배양하고 현장감 있는 학습자료 개발을 하지 않으면 안 된다.
한편, 임상에서 지적하고 있는 문제점은 현장적응력 부족과 병원에서 검사하지 않는 검사법
및 내용소개 등의 공급자 중심의 교육, 전공 관련 기술과 환경변화에 맞는 요검사학 교재 개발
이 없다는 점이다. 따라서 대학은 임상현장의 연계된 직업교육에 더욱 충실하여야 하며 이를
위해서는 산업협력의 기술과 환경변화에 맞는 새로운 교재 개발이 필수라고 생각하면서 수요
자 중심의 교육을 통한 인재 양성을 하여야 한다.
본 교재는 산업체와 연계된 실무중심의 검사내용을 위주로 하여 과도한 이론강의는 피하고
핵심내용만을 간결히 기술하기 위해 노력하였다. 임상현장에 부합된 Routine urinalysis 검사항
목과 요침사의 현미경적 검사에서 다양한 특수 현미경에 의한 정상 및 비정상 요침사를 계통
적으로 Color 사진과 함께 소개하였으며, 현재 병원에서 주로 검사하지 않는 검사법은 기타 측
정법이란 장에서 간단히 소개하였다. 아울러 의과대학이나 대학의 임상병리학과를 전공하는
학생들에게 적합한 참고서가 되길 바랄 뿐이다.
또한 임상현장에 적합한 교재를 준비하면서 최선을 다하고자 심혈을 기울였으나 부족한 부
분이나 아쉬운 점 또는 조언해 줄 부분이 있다면 겸허하게 수용하고 개정판이 출간될 때 적극
수정·보완할 것을 다짐드리며, 본 교재가 완성되기까지 노고를 아끼지 않으시면서 집필에 최
선을 다해 주신 여러 교수님 그리고, 본 교재의 출판을 위해 물심양면으로 도와주신 고려의학
최병진 사장님과 임직원 여러분께 진심으로 감사를 드립니다.
2015년 2월
저자
목차목 차
chapter 01. 비뇨기계와 요 / 3
1. 신장의 구조 · ···························································· 4
2. 요 형성과정 · ···························································· 8
3. 요의 농축 · ···························································· 13
4. 요의 산성화 · ·························································· 13
5. 배 뇨 ·································································· 18
⊙ 핵심요약 및 실전문제 · ················································ 21
chapter 02. 요검사 / 23
1. 요검사의 의의 ························································· 23
2. 요검사의 중요성 · ····················································· 24
⊙ 핵심요약 및 실전문제 · ················································ 25
chapter 03. 요의 채취 / 27
1. 요의 채취 · ···························································· 27
2. 채뇨방법 ······························································ 28
3. 요와 체액의 구별법 ···················································· 31
4. 정상 요량(Urine volume) ·············································· 32
⊙ 핵심요약 및 실전문제 · ················································ 35
chapter 04. 요의 보존법 / 37
1. 요의 보존 방법 · ······················································· 38
2. 오차의 원인 · ·························································· 41
⊙ 핵심요약 및 실전문제 · ················································ 42
chapter 05. 일상뇨 검사 / 43
1. 일상뇨 검사(Routine urinalysis) · ······································ 43
2. 일상뇨의 검사 종목 ···················································· 44
3. 기타 Special tests · ···················································· 45
⊙ 핵심요약 및 실전문제 · ················································ 46
chapter 06. 물리적 검사 / 47
1. 요색(Color) · ·························································· 47
2. 혼탁도(Turbidity) · ···················································· 49
3. 냄새(Odor) · ·························································· 51
⊙ 핵심요약 및 실전문제 · ················································ 53
chapter 07. 화학적 검사 / 55
1. pH ···································································· 57
2. 비중(Specific gravity; S.G) · ··········································· 59
3. 요비중계(urinometer) ················································· 64
4. 단백뇨(Proteinuria) · ·················································· 65
5. 당뇨(Urine sugars) · ··················································· 75
6. 케톤체(ketone body) ·················································· 82
7. 잠혈반응(Occult blood) · ·············································· 85
8. Bilirubin · ····························································· 91
9. Urobilinogen · ························································ 99
10. Nitrite · ····························································· 103
11. Leukocyte esterase ················································· 106
12. Ascorbic acid · ······················································ 107
13. Random urine specimen의 참고치 · ································· 108
14. Routine urinalysis의 적용 및 임상적 의의 ···························· 110
⊙ 핵심요약 및 실전문제 · ··············································· 111
목 차
chapter 08. 세균뇨 / 123
1. 임상적 의의 · ························································· 123
2. 검체채취방법 · ······················································· 124
3. 요의 보존조건 ························································ 124
4. 화학적 간이측정법 · ·················································· 124
⊙ 핵심요약 및 실전문제 · ··············································· 129
chapter 09. 요침사 검경 / 131
1. 의의 · ································································ 131
2. 요침사(Urine sediment) ·············································· 131
3. 요침사의 종류 ························································ 139
4. 요침사의 현미경학적인 특성 ·········································· 141
5. 요침사의 검경시 오차 · ··············································· 171
⊙ 핵심요약 및 실전문제 · ··············································· 172
chapter 10. 요침사의 현미경적 형태 / 175
1. 적혈구(Red blood cells) ·············································· 175
2. 백혈구(White blood cells) ············································ 178
3. 상피세포(Epithelial cells) · ··········································· 180
4. 원주(Casts) · ························································· 184
5. 결정체(Crystals) ······················································ 190
6. 기타의 요침사(Other urinary sediments) ······························ 202
chapter 11. 요침사의 관찰 / 209
1. 적혈구(Red blood cells) ·············································· 209
2. 백혈구(White blood cells) ············································ 215
3. 상피세포(Epithelial cells) · ··········································· 222
4. 원주(Casts) · ························································· 227
5. 산성뇨에서 검출되는 결정체(Crystals) · ······························· 236
6. 알칼리성뇨에서 검출되는 결정체 · ···································· 248
7. 기타의 요침사(Other urinary sediments) ······························ 250
chapter 12. 요침사의 염색법 / 257
chapter 13. 임신검사 / 267
1. 개요 · ································································ 267
2. 임상적 의의 · ························································· 268
3. 검사방법 ····························································· 268
chapter 14. Urobilin / 275
1. 개요 · ································································ 275
2. 검사방법 ····························································· 275
chapter 15. Indican / 277
1. 개요 · ································································ 277
2. 임상적 의의 · ························································· 277
3. 검사방법 ····························································· 278
chapter 16. Porphyrin / 281
1. 개요 · ································································ 281
2. 임상적 의의 · ························································· 281
3. 참고사항 ····························································· 282
4. 검사방법 ····························································· 283
목 차
chapter 17. Phenylketonuria / 287
1. 개요 · ································································ 287
2. 검사방법 ····························································· 288
chapter 18. Alkaptonuria / 291
1. 개요 · ································································ 291
2. 임상적 의의 · ························································· 291
3. 검사방법 ····························································· 291
chapter 19. Melanin / 293
1. 개요 · ································································ 293
2. 임상적 의의 · ························································· 293
3. 검사방법 ····························································· 293
chapter 20. 칼슘 / 297
1. 개요 · ································································ 297
2. 임상적 의의 · ························································· 297
3. 검사방법 ····························································· 297
chapter 21. Vanillylmandelic acid(VMA) / 299
1. 개요 · ································································ 299
2. 임상적 의의 · ························································· 299
3. 검사방법 ····························································· 299
chapter 22. 17-OHCS / 301
1. 개요 · ································································ 301
2. 임상적 의의 · ························································· 301
3. 검체 취급 · ··························································· 301
4. 검사방법 ····························································· 302
5. 유의사항 ····························································· 302
6. 기준치 · ······························································ 302
chapter 23. 5-HIAA / 303
1. 개요 · ································································ 303
2. 임상적 의의 · ························································· 303
3. 검체 취급 · ··························································· 304
4. 검사방법 ····························································· 304
5. 유의사항 ····························································· 304
6. 기준치 · ······························································ 305
chapter 24. 17-KS(17-Ketosteroids) / 307
1. 개요 · ································································ 307
2. 임상적 의의 · ························································· 307
3. 검체 취급 · ··························································· 308
4. 검사방법 ····························································· 308
5. 유의사항 ····························································· 308
6. 기준치(성인) ························································· 308
chapter 25. NAG test / 309
1. 개요 · ································································ 309
2. 임상적 의의 · ························································· 309
3. NAG의 측정방법 · ···················································· 310
4. 유의사항 ····························································· 310
5. 기준치 · ······························································ 310
목 차
chapter 26. Addis count / 311
1. 개요 · ································································ 311
2. 시 약 ································································· 311
3. 검사방법 ····························································· 311
chapter 27. 기타 체액검사 / 313
1. 정액검사(Semen analysis) ············································ 313
2. 뇌척수액(Cerebrospinal fluid) ········································ 314
3. 양수(Amniotic fluid) · ················································ 315
4. 위액(Gastric juice) · ·················································· 315
5. 장액(intestinal juice) · ················································ 316
6. 활액(Synovial juice) ·················································· 316
⊙ 핵심요약 및 실전문제 · ··············································· 317
chapter 28. 요검사의 정도관리(QC) / 329
1. 의의 · ································································ 329
2. 정도관리란? ·························································· 329
3. 정도관리 물질이란? · ················································· 330
4. 정도관리의 종류 · ···················································· 330
5. 정도관리 물질 선정 시 고려할 항목들 · ································ 331
6. 검사 결과의 해석 ····················································· 336
7. 요검사시험지와 정도관리 · ··········································· 337
8. 상품화된 URiTROL level 1,2,3(YD)의 요검사
정도관리물질 조제 및 사용방법 ······································· 343
9. Checkstix(Ames)를 이용한 정도관리 · ································ 344
10. 정도관리 신빙도 조사(1999년) · ····································· 345
11. 기록방법 ···························································· 347
12. 요침사의 정도관리 · ················································· 349
chapter 29. 부 록 I / 355
chapter 30. 부 록 II -인증평가관련 요검사분야의 지침서- / 361
찾아보기 · ······························································ 385
INDEX · ································································ 389
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