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患者,男,28岁。因无痛、间歇性血尿9个月,伴头昏、乏力4天,于1984年1月23日入院。患者于9个月前突然出现肉眼全程血尿,伴尿频、尿急,无血块及疼痛。在某医院诊断为“尿路感染”,经治疗后血尿消失、症状缓解。1月后再次出现血尿,其后每月出现血尿1～2次,每次1～3天。 体检:体温36.7℃,脉搏112次,血压80/50。贫血貌,中度脱水。心前区可闻及Ⅱ级收缩期杂音。肛门指诊,前列腺上方可扪及一鸭蛋大小包块,表面光滑,固定。化验:血红蛋白4.5g。白细胞11690,中性83％。肝、肾功能正常,尿培养无菌生长。B超:膀胱右后上可探及长9cm、厚5.5cm、宽6.5cm边缘不规则之低回声区,并突向膀胱腔内。 治疗经过:入院后经补液、输血及止血治疗,血
Patient, male, 28 years old. Due to painless, intermittent hematuria 9 months, with dizziness, fatigue for 4 days, January 23, 1984 admission. The patient suddenly showed gross hematuria 9 months ago with frequent urination, urgency, no clots and pain. In a hospital diagnosed as “urinary tract infection,” hematuria disappeared after treatment, symptoms were relieved. Hematuria again after January, followed by hematuria every month 1 or 2 times, each 1 to 3 days. Physical examination: body temperature 36.7 ℃, pulse 112 times, blood pressure 80/50. Anemia appearance, moderate dehydration. Heart area can be heard and Ⅱ systolic murmur. Anatomy of the anus, the palpable above the prostate and a duck egg size package, the surface is smooth, fixed. Assay: Hemoglobin 4.5g. White blood cells 11690, neutral 83%. Liver, kidney function is normal, urine culture aseptic growth. B super: the right back of the bladder can be explored and 9cm long, 5.5cm thick, 6.5cm wide and irregular edge of the hypoechoic area, and protruding into the bladder cavity. After treatment: rehydration after admission, blood transfusion and hemostasis, blood