膀胱平滑肌瘤的诊断和治疗的探讨

The diagnosis and treatment for leiomyomaof bladder

目的 对膀胱平滑肌瘤临床诊治进行回顾性分析，以提高其诊断和治疗水平。方法：2004-2005年连续诊治3例膀胱平滑肌瘤患者，临床有血尿症状2例，体检发现1例。行B超、KUB＋IVP、CT等检查示1例膀胱与子宫间占位，1例示膀胱内病灶生长，1例早期B超无明显异常。膀胱镜下3例均见膀胱内局部隆起，黏膜表面光整。3例均在连续硬膜外麻醉下行膀胱部分切除术治疗。结果 3例病灶均完整切除，术后随访4～5年无复发。结论 膀胱平滑肌瘤是少见的膀胱良性肿瘤，对其诊断主要依靠影像学及膀胱镜检查，必要时可取病理活检以防误诊，外科手术可获得良好的治疗效果。

Objective To improve the diagnosis and treatment for leiomyoma of bladder by retrospective analysis of cases of leiomyoma. Methods The clinical data of 3 patients with leiomyoma from 2004 - 2005 in our hospital were analyzed. Two cases had the symptom of blood urine, and one had no symptom. B type ultrasonography and CT revealed a neoplasm between the bladder and hystera,a bladder neoplasm, no apparent abnormality in another case. Cystoscopy showed evections partly in three cases. Both 3 cases were treated by bladder partial excision with continuous epidural anesthesia. Results All patients received the partial cystectomy and were excised the tumor fully. The patients were followed up 4 to 5 years with no recurrence. Conclusions Leiomyoma of bladder is rare benign tumor. Its diagnosis needs B type ultrasonography, CT, cystoscopy and pathology. Radical resection of the tumor can achieve good prognosis.