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患者,女,68岁。因不能自行排尿,外院治疗半月无效转来我院。发病初为尿频、尿急、排尿困难。当地医院给予留置导尿及抗感染治疗。在我院门诊做B超检查,探及膀胱内有一6cm×5cm×3cm肿物。以膀胱肿瘤合并下尿路梗阻收住院。体检:一般情况可,神情,反应迟钝(老年性痴呆症)。心肺听诊正常,肝脾未触及。双肾区及输尿管走行区触诊未发现异常。小腹部膨隆,浊音区近脐部,导出尿液900ml。阴道、腹部双合诊可触及盆腔内鸡卵大小肿物,光滑、有一定活动度。实验室检查:Hb140g/L,WBC 7.4×10~9/L,中性白细胞62％,淋巴细胞29％,嗜酸性白细胞9％。尿常规:蛋白(++)、白细胞每高倍视野3～4个。于入院第3日查膀胱镜,见膀胱粘膜粗糙,有小梁及陷窝形成,于左前壁近尿道内口处有一肿物,大小同B超所见,表面呈草莓状,紫红色,取活组织
Patient, female, 68 years old. Because they can not urinate on their own, half of the hospital invalid transfer to our hospital. Early onset of urinary frequency, urgency, dysuria. Local hospital for catheterization and anti-infective treatment. In our clinic do B-ultrasound, exploration and the bladder has a 6cm × 5cm × 3cm tumor. Urinary tract obstruction with urinary bladder tumor admitted to hospital. Physical examination: the general situation can be, look, unresponsive (Alzheimer’s disease). Cardiopulmonary auscultation normal, liver and spleen not touched. Nephrotic and ureter walking area palpation found no abnormalities. Small abdominal bulging, voiced sound near the umbilical area, derived urine 900ml. Vagina, abdomen, double clinics can reach the size of pelvic hemangiomas, smooth, there is a certain degree of activity. Laboratory tests: Hb140g / L, WBC 7.4 × 10 ~ 9 / L, neutrophils 62%, lymphocytes 29%, eosinophils 9%. Urine: protein (++), leukocytes per high power field 3 to 4. Check the cystoscopy on the 3rd day of admission, see the rough bladder mucosa, trabecular and lacuna formation, in the left anterior wall near the mouth of the urethra with a tumor, the size of the same see B, the surface was strawberry-like, purple, Take living tissue