膀胱平滑肌瘤的临床诊疗分析

程伟松 刘晟

[摘要] 目的 对膀胱平滑肌瘤患者的临床诊断和治疗进行回顾性分析，从而更好地提高临床诊断和治疗水平。 方法 收集2009年1月至2020年3月期间在台州市立医院病理确诊为膀胱平滑肌瘤的12例患者，其中血尿患者1例，排尿困难患者1例，尿频、尿急患者1例，无明显临床症状的患者9例。11例患者影像学检查提示膀胱内占位表现。1例患者影像学检查未发现异常，膀胱镜检查发现膀胱颈口近前列腺处肿物。11例患者行经尿道膀胱肿瘤剜除术，1例患者行经尿道膀胱肿瘤电切术。 结果 11例患者完整剜除肿瘤，1例患者行膀胱肿瘤电切，术后病理诊断为膀胱平滑肌瘤。行膀胱肿瘤电切的患者术后4年复发，余患者随访无复发。 结论 膀胱平滑肌瘤通常无明显临床表现，可通过影像学及膀胱镜检查及时发现病变，外科手术通常可取得理想的治疗效果。

[关键词] 膀胱;良性肿瘤;平滑肌瘤;诊断

[中图分类号] R737.14          [文献标识码] B          [文章编号] 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）是膀胱间叶组织的良性肿瘤，临床非常少见，占所有膀胱肿瘤的0.05%[1-2]。女性膀胱平滑肌瘤的發生率是男性的3倍，高发年龄为40～50岁。膀胱平滑肌瘤多为良性，具有极低的恶性潜能（0.1%），多数无临床症状，仅部分伴有局部侵袭性及排尿困难等症状，临床诊断较困难，初诊的误诊率较高[2，21]。其主要检查方法为影像学和膀胱镜检查，确诊需要病理学诊断;其主要治疗方法为外科手术，通常预后良好。本研究选取2009年1月至2020年3月在我院病理确诊为膀胱平滑肌瘤的12例患者，对其临床资料进行回顾性分析，探讨膀胱平滑肌瘤的诊断与治疗特点，提高对该病的诊疗水平。