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患者,男,18岁,因排尿时头昏眼花,伴肉眼血尿4月于1985年4月16日入院。体检:一般情况好,BP26.7/18.7kPa(200/140mmHg),巩膜未见黄染,心肺正常,腹部未见异常。血常规:Hb10g/dl,WBC9600/mm~3,N 70%,L 30%;尿常规:蛋白微量,红细胞(+);肝肾功能正常。B超和IVP示:左肾盂轻度积水。VMA呈弱阳性。挤压膀胱和排尿时测量血压,由17.3/10.7kPa升至26.7/18.7kPa(130/80mmHg～200/140mmHg)。膀胱镜检示:膀胱左侧壁有一3×4 cm大小、广基、突出于膀胱粘膜、表面有坏死的肿物,侵犯左输尿管口。术前拟诊:膀胱嗜铬细胞瘤。经服用苯苄胺及扩容后于1985年5月3日在硬膜外麻醉下行膀胱部分切除十输尿管膀胱移植术。术中血压平稳,无明显波动,术后无需升压药物维持血压。
Patient, male, 18 years old, dizzy with micturition, with gross hematuria April was admitted to hospital on April 16, 1985. Physical examination: the general situation is good, BP26.7 / 18.7kPa (200 / 140mmHg), sclera no yellow dye, normal heart and lungs, abdomen no abnormalities. Blood: Hb10g / dl, WBC9600 / mm ~ 3, N70%, L30%; urine routine: protein trace, red blood cells (+); liver and kidney function is normal. B-and IVP shows: mild left pelvis hydronephrosis. VMA was weakly positive. Blood pressure was measured at bladder squeezing and urination from 17.3 / 10.7 kPa to 26.7 / 18.7 kPa (130/80 mmHg to 200/140 mmHg). Cystoscopy: the left side of the bladder has a 3 × 4 cm size, wide base, prominent in the bladder mucosa, the surface necrosis of the tumor, violation of the left ureteral orifice. Preoperative diagnosis: bladder pheochromocytoma. After taking benzene benzylamine and expansion in May 3, 1985 in the epidural anesthesia under partial bladder resection ten ureter bladder transplants. Intraoperative blood pressure was stable, no significant fluctuations, no need to step up the pressure of blood pressure after surgery.