膀胱平滑肌瘤的臨床診療分析

程偉松 劉晟

[摘要] 目的 對膀胱平滑肌瘤患者的臨床診斷和治療進行回顧性分析，從而更好地提高臨床診斷和治療水平。 方法 收集2009年1月至2020年3月期間在臺州市立醫(yī)院病理確診為膀胱平滑肌瘤的12例患者，其中血尿患者1例，排尿困難患者1例，尿頻、尿急患者1例，無明顯臨床癥狀的患者9例。11例患者影像學(xué)檢查提示膀胱內(nèi)占位表現(xiàn)。1例患者影像學(xué)檢查未發(fā)現(xiàn)異常，膀胱鏡檢查發(fā)現(xiàn)膀胱頸口近前列腺處腫物。11例患者行經(jīng)尿道膀胱腫瘤剜除術(shù)，1例患者行經(jīng)尿道膀胱腫瘤電切術(shù)。 結(jié)果 11例患者完整剜除腫瘤，1例患者行膀胱腫瘤電切，術(shù)后病理診斷為膀胱平滑肌瘤。行膀胱腫瘤電切的患者術(shù)后4年復(fù)發(fā)，余患者隨訪無復(fù)發(fā)。 結(jié)論 膀胱平滑肌瘤通常無明顯臨床表現(xiàn)，可通過影像學(xué)及膀胱鏡檢查及時發(fā)現(xiàn)病變，外科手術(shù)通常可取得理想的治療效果。

[關(guān)鍵詞] 膀胱;良性腫瘤;平滑肌瘤;診斷

[中圖分類號] R737.14? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）24-0107-03

Analysis on the clinical diagnosis and treatment of bladder leiomyoma

CHENG Weisong? ?LIU Sheng

Department of Urology Surgery， Taizhou Municipal Hospital in Zhejiang Province， Taizhou? ?318000， China

[Abstract] Objective To analyze the clinical diagnosis and treatment of bladder leiomyoma retrospectively， so as to better improve its clinical diagnosis and treatment level. Methods A total of 12 patients with bladder leiomyoma diagnosed pathologically in Taizhou Municipal Hospital from January 2009 to March 2020 were collected， in which 1 patient with hematuria， 1 patient with dysuria， 1 patient with frequent micturition and urgency， and 9 patients without obvious clinical symptoms were included. Bladder occupation was shown by imaging examination of 11 patients. No abnormality was found in the imaging examination of 1 patient， but a tumor near the prostate was found by cystoscopy. 11 patients were treated with transurethral enucleation of bladder tumor and 1 patient was treated with transurethral resection of bladder tumor. Results The tumors were completely enucleated in 11 patients， 1 patient was treated with bladder tumor resection， and the postoperative pathological diagnosis was bladder leiomyoma. Patients who were treated with bladder tumor resection relapsed 4 years after operation， and the remaining patients were followed up without relapse. Conclusion Bladder leiomyoma usually has no obvious clinical manifestations. The lesions can be found in time by imaging and cystoscopy. And the surgery can usually achieve ideal therapeutic efficacy.

[Key words] Bladder; Benign tumor; Leiomyoma; Diagnosis

膀胱平滑肌瘤（Bladder leiomyoma，BL）是膀胱間葉組織的良性腫瘤，臨床非常少見，占所有膀胱腫瘤的0.05%[1-2]。女性膀胱平滑肌瘤的發(fā)生率是男性的3倍，高發(fā)年齡為40～50歲。膀胱平滑肌瘤多為良性，具有極低的惡性潛能（0.1%），多數(shù)無臨床癥狀，僅部分伴有局部侵襲性及排尿困難等癥狀，臨床診斷較困難，初診的誤診率較高[2，21]。其主要檢查方法為影像學(xué)和膀胱鏡檢查，確診需要病理學(xué)診斷;其主要治療方法為外科手術(shù)，通常預(yù)后良好。本研究選取2009年1月至2020年3月在我院病理確診為膀胱平滑肌瘤的12例患者，對其臨床資料進行回顧性分析，探討膀胱平滑肌瘤的診斷與治療特點，提高對該病的診療水平。