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【医学ppt课件】原发性支气管肺癌(68p)

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医学ppt课件 【医学ppt课件】原发性支气管肺癌68p
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Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 原发性支气管肺癌 Primary bronchogenic carcinoma 河南医科大学一附院呼吸内科 王 静 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 【【概述】】 原发性支气管肺癌Primary bronchogenic carcinoma(简称肺 癌 Lung carcinoma)是指起源于 支气管粘膜上皮和腺上皮和肺泡上 皮的恶性肿瘤。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 【【病因和发病机制】】 一、吸烟: 二、环境污染 三、电离幅射 四、其他因素 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 【【病理和分类】】 一、按解剖部位分类 (一)中央型肺癌 段支气管以上 (二)周围型肺癌 段支气管以下 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 肺 癌 的 生 长 部 位 — Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 肺癌的生长方式: 一 向管腔内生长 二 沿管壁生长 三 向管腔外生长 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 生长方式: 正常支气管 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 向 管 腔 内 生 长 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 沿 管 壁 生 长 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 向 管 腔 外 生 长 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 二、按组织学分类(国内) (一)鳞状上皮细胞癌(简称鳞癌) (Squamous carcinoma) (二)小细胞未分化癌(简称小细胞癌) (Small cell carcinoma) (三)大细胞未分化癌(大细胞癌) (Large cell carcinoma) (四) 腺癌(Adenocarcinoma) Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 二、按组织学分类 (一)鳞状上皮细胞癌(简称鳞癌) (Squamous carcinoma) 是最常见的 类型.多见于老 年男性,与吸 烟关系密切。 以中央型多见 ,多向管腔内 生长。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 早期 引起支 气管狭 窄,导 致肺不 张,或 阻塞性 肺炎。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 癌组织易变性 、坏死,形成 空洞 或癌性肺 脓肿。鳞癌生 长缓慢,转移 晚,手术切除 的机会相对多 ;但对放射治 疗、化学药物 治疗不敏感。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. (二)小细胞未分化癌(简称小细胞 癌)Small cell carcinoma 是肺癌中恶性程度最高的一种,患者 年龄较轻,多在40-50岁左右,多有吸烟 史。多发生于肺门附近的大支气管,倾向 于粘膜下层生长,常侵犯支气管外肺实质 ,易侵犯肺门、纵隔淋巴结。癌细胞生长 快,侵袭力强,远处转移早.放疗化疗均 敏感。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 燕麦细胞型 具有内分泌和化学受体功能, 能分泌5-羟色胺、儿茶酚胺、组胺 、激肽等肽类物质,可引起副癌综 合征(paraneoplastic syndrome) 。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. (三)大细胞未分化癌(大细胞癌) (Large cell carcinoma) 可发生在肺门附近或肺边缘的支 气管。大细胞癌转移较小细胞未分化 癌晚,手术切除机会较大。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. (四)腺癌 (Adenocarcinoma) 女性多见,与 吸烟关系不大,多 生长在肺边缘,多 呈周围型。倾向于 管外生长,常在肺 边缘部形成直径2 一4cm的肿块。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 腺癌血管 丰富,故局部 浸润和血行转 移较鳞癌早。 易转移至肝、 脑和骨,更易 累及胸膜而引 起胸腔积液。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 细支气管-肺泡癌(简称肺泡癌) (Bronchioloalveolar carcinoma) 是腺癌的--个亚型. 表现有结节型与弥漫型 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 结节型肺泡 细胞癌 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 弥漫型肺泡细胞癌 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 【【临床表现】】 一、由原发肿瘤引起的症状 二、肿瘤局部扩展引起的症状 三、由癌肿远处转移引起的症状 四、癌肿作用于其他系统引起的 肺外表现 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 一、由原发肿瘤引起的症状 (一)咳嗽 (二)咯血 持续痰中带血 (三)喘鸣 (四)胸闷、气急 (五)体重下降 (六)发热 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 二、肿瘤局部扩展引起的症状 (一)胸痛 侵犯胸膜、肋骨和胸壁 (二)呼吸困难 (三)咽下困难 癌肿侵犯或压迫食管 (四)声音嘶哑 癌肿直接压迫或转移至 纵隔淋巴结肿大后压迫喉返神经 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. (五)上腔静脉阻塞综合征 癌肿侵犯纵隔,压迫上腔静脉。 (六)Horner综合征 位于肺尖部的肺癌称上沟癌 (Pancoast carcinoma),压迫颈部交 感神经。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 三、由癌肿远处转移引起的症状 (一)肺癌转移至脑、中枢神经系统 (二)转移至骨骼 (三)转移至肝 (四)肺癌转移至淋巴结 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 四、癌肿作用于其他系统引起 的肺外表现 (副癌综合征)。 1. 肥大性肺性骨关节病杵状指 (趾) Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 2·男性乳房发育 促性腺激素 3. Cushing综合征 促肾上腺皮质激素 样物 4·稀释性低钠血症 抗利尿激素 5·神经肌肉综合征 6·高血钙症 肺癌可因转移而致骨骼破 坏,或由异源性甲状旁腺样激素引起。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 【【影像学及其他检查 】】 一、胸部X线检查 二、电子计算机体层扫描 (computed tomography CT) CT的优点在于能发现普通X线检查 不能显示的解剖结构; (一)中央型肺癌 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. (二)周围型肺癌 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 周围型肺癌 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 周围型肺癌并肺门淋巴结转移 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 细支气管-肺泡癌 (Bronchioloalveolar carcinoma) 有两种类型的表现。 结节型与弥漫型 结节型与周围型肺癌的圆型病 灶不易鉴别。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 肺癌胸膜转移-胸腔积液 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 三、磁共振 (magnetic resonance imaging,MRI) 四、痰脱落细胞检查 五、纤维支气管镜检查 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 六、开胸手术探查 七、转移灶活检 对转移病灶施行活检,如肝、 淋巴结、骨骼或骨髓等。肿瘤累 及胸膜时胸腔穿刺结合胸膜活检 可提高临床确诊率。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 七、其他检查 癌相关抗原,如癌胚抗原(CEA) 肿瘤细胞生长因子(TSGF) 八、胸水化验 血性,渗出液,LDH>500 U/L,ADA<50 U
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