原发性膀胱淀粉样变临床诊治分析  

Diagnosis and therapy of primary amyloidosis of the bladder

作　　者：王深[1] 欧阳骏[1] 侯建全[1] 樊彩斌[1] 

机构地区：[1]苏州大学附属第一医院泌尿外科,江苏苏州215006

出　　处：《中国现代医学杂志》2011年第27期3383-3386,共4页China Journal of Modern Medicine

摘　　要：目的探讨原发性膀胱淀粉样变的诊断和治疗,提高对原发性膀胱淀粉样变的认识。方法回顾性分析该院3例原发性膀胱淀粉样变的临床资料并文献复习。结果该病多发于中老年人,临床上多表现为无痛性肉眼血尿。2例行经尿道病变电切术,术后辅以二甲基亚砜膀胱灌注,随访3～9年,未见复发。1例行膀胱部分切除术,一年后复发,最终行膀胱全切尿流改道术,随访至今健在。结论该病临床上罕见,原发性膀胱淀粉样变极易和膀胱癌混淆,主要依赖于病理学检查和刚果红复染反应确诊,治疗上尽可能行经尿道病变切除术,术后辅以二甲基亚砜膀胱灌注可降低复发率,尽量避免膀胱全切术。[ Objective ] To detect the diagnostic and therapic methods of primary amyloidosis of the bladder, improve the understanding of this disease. [Methods] Reviewed 3 cases in our hospital and the published papers of primary amyloidosis of the bladder. [ Results ] The disease usually occurs in older adults and the classical presentation is gross painless hematuria. Two patients received transurethral resection associated with dimethyl sulfoxide instillation, none recurrence was found at the 3 to 9 years follow-up. One patient received partial eystectomy and the disorder was recurred after one year. Finally, the patient performed total resection of the urinary diversion and still alive. [ Conclusions] Primary amyloidosis of the bladder is a rare disease, it may be easily confused with carcinoma of the bladder. Definitive diagnosis mainly rests on pathology examination and Congo red after dyeing reaction. The rules of the treatments include resecting the lesions as more as possible. Dimethyl sulfoxide instillation is helpful to decrease the recurrence rate, as far as possible to avoid total resection.

关 键 词：淀粉样变 膀胱 诊断 治疗 

分 类 号：R694[医药卫生—泌尿科学]