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目的 探讨局部进展期结直肠癌侵犯膀胱的临床特点及其诊断。方法 回顾性分析 12年间收治的2 9例结直肠癌侵犯膀胱的病人资料。结果 原发癌 2 6例和复发癌 3例。常见症状为排便习惯与粪便性状改变2 0例 (占 6 9 0 % ) ,其次为腹痛 16例 (5 5 2 % )、泌尿系统症状 15例 (5 1 7% )、体重下降 12例 (41 4 % )和食欲减退 8例 (2 7 6 % )。常见体征为腹部包块 11例 (37 9% )和直肠肿物 7例 (2 4 1% )。B超、结肠镜、膀胱镜和盆腔CT扫描检查发现肿物的阳性率分别为 93 8% (15 / 16 )、95 0 % (19/ 2 0 )、91 7% (11/ 12 )和 10 0 % (18/ 18)。入院前误诊率达 6 2 1% (18/ 2 9) ,入院时误诊率为 4 4 8% (13/ 2 9)。结论 本病缺乏特异性临床表现而易误诊 ,应根据本病的临床特点 ,并结合B超、结肠镜、膀胱镜和盆腔CT扫描检查而作出正确的诊断
Objective To investigate the clinical features and diagnosis of locally advanced colorectal cancer invading the bladder. Methods The data of 29 cases of colorectal cancer invading the bladder during 12 years were retrospectively analyzed. Results 26 cases of primary cancer and 3 cases of recurrent cancer. The common symptoms were 20 cases (69.0%) of defecation habits and stool traits, followed by 16 cases (54.2%) of abdominal pain, 15 cases (51.7%) of urinary symptoms and 12 cases of weight loss 4%) and loss of appetite in 8 cases (276%). Common signs were abdominal mass in 11 cases (37 9%) and rectal mass in 7 cases (21 4%). The positive rates of tumor mass were 93.8% (15/16), 95 0% (19/20), 91 7% (11/12) and 10 0% (18/18). The rate of misdiagnosis before admission was 621% (18/29), and the rate of misdiagnosis at admission was 44.8% (13/229). Conclusion The disease lacks specific clinical manifestations and is easily misdiagnosed. Correct diagnosis should be made according to the clinical features of the disease combined with B-mode ultrasound, colonoscopy, cystoscopy and pelvic CT scan.