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沃辛瘤 Warthin tumor 学习内容 learning content 相关病例Related Case 相关知识Related knowledger 护理评估Nursing assessment 护理问题/诊断Nursing problems/ Diagnosis 护理措施Nursing measures 护理评价Nursing evaluation 一、病例 傅国林，男，57岁，已婚。主诉双侧耳垂下无痛渐大性肿物四月余。门诊B超示：双侧腮腺多发实性低回声团。诊断：“双侧腮腺warthin瘤”。有饮酒史及30年吸烟史。手术室行双侧腮腺肿物及腮腺全叶切除术加面神经解剖术。术后生命体征正常。 专科检查：患者左侧颜面部稍大，额纹、鼻唇沟正常，嘴角无偏斜。左侧腮腺区可扪及一大小约为3×2cm肿物，质稍硬，无触痛，边界清楚，活动度可，与周围组织无明显粘连：右侧腮腺区可扪及一大小约为4×3cm的肿物，质稍硬，无触痛，边界较清，活动度一般，与周围组织无明显粘连。 诊断：双侧腮腺warthin瘤 Case Fuguorong，male，57 years old，married。Chief Complaint：Under the bilateral earlobe painless mass than April. Outpatient B-：Bilateral parotid multiple hypoechoic solid group. Diagnosis ：Bilateral Warthin tumor。Past history：There are drinking, smoking history of 30 years. Treatment：Bilateral parotid tumor resection，Bilateral parotid full lobectomy and Facial nerve surgery. Postoperative vital signs were normal. Specialist examination：Slightly larger than the left side of the patient facial, forehead lines, nasolabial normal, mouth without deflection. The left parotid gland and a palpable tumor size of about 3 × 2cm, quality slightly harder, no tenderness, clear boundary activity can, with the surrounding tissue without significant adhesions: The right parotid gland about the size of a palpable 4 × 3cm mass, quality slightly harder, no tenderness, the border was clear, the activity in general, no significant adhesions with the surrounding tissue. Diagnosis：Bilateral Warthin tumor. 二、相关知识Related knowledger Warthin 瘤又称腺淋巴瘤或乳头状淋巴囊腺瘤,1895 年Hildebrad 首先报道了这种肿瘤, 1929 年Warthin 创用乳头状淋巴囊腺瘤, 至1991 年WHO 关于涎腺肿瘤新分类中正式提出用Warthin 瘤这一名称 。它是涎腺肿瘤中发病率仅次于多形性腺瘤的常见肿瘤, 绝大部分发生于腮腺。 腺淋巴瘤的组织发生来源观点不一，大多数人认为发生自残存于邻近淋巴结内的异位涎腺组织。免疫学研究证明本瘤组织中的淋巴组织，主要由T淋巴细胞及少数B淋巴细胞组成。超微结构观察提示这些淋巴组织是细胞介导免疫反应的结果。故认为本病瘤组织内的淋巴样成分来源于腮腺区正常或反应性淋巴结组织，不参与肿瘤的形成和生长。 Warthin tumor, also known as lymph gland lymphoma or papillary cystadenoma. 1895 Hildebrad first reported this tumor, 1929 Warthin Creative papillary cystadenoma lymph to the WHO 1991 classification