全科中级辅导外科和急救课件.pptVIP

Company Logo Company Logo Company Logo Company Logo * * * * * * * * * * * * * (forty,fat.female,fruitful 4F) Company Logo Company Logo Company Logo Company Logo （A）病人站立，大腿上1/3扎上止血带；（B）交替伸屈膝关节10余次或行走； （C）静脉曲张益形明显，小腿胀痛，即为深静脉通畅试验阳性 Company Logo Company Logo Company Logo Company Logo This is a renal cell carcinoma arising in the lower pole of the kidney. It is fairly circumscribed. The cut surface demonstrates a variegated appearance with yellowish areas, white areas, brown areas, and hemorrhagic red areas. Though these neoplasms are usually slow-growing, they can often reach a considerable size before detection because there is a lot of room to enlarge in the retroperitoneum, and there is another kidney to provide renal function. Thus, presenting symptoms and signs usually include flank pain, mass effect, and hematuria. Company Logo This is a much more advanced renal cell carcinoma involving the left kidney (top). Notice a huge mass of necrotic yellowish brown material replacing the lower pole of the kidney. Also notice that the vena cava in the center of the picture is filled with tumor. This is typical of this neoplasm. In the upper pole of this kidney is a well circumscribed tumor which has a yellowish-brown color and shows central necrosis. This is a renal cell carcinoma. Company Logo Company Logo 膀胱癌Tis 膀胱癌Ta-1 膀胱癌临床分类分期 Company Logo 膀胱癌临床分类分期 膀胱癌T2-3 膀胱癌T4 Company Logo Company Logo 膀胱肿瘤 治疗 手术治疗为主。 （一）表浅膀胱肿瘤 原位癌 细胞分化不良、已经有浸润的应及早行膀胱全切术；细胞分化良好的可行经尿道手术。 （二）浸润性膀胱肿瘤 1、分化良好、局限的T2期肿瘤可行经尿道手术。 2、一般根据肿瘤浸润范围、大小、数目选择膀胱全切术或膀胱部分切除术，部分切除范围应包括距离肿瘤2cm以内的全层膀胱壁。 3、膀胱全切术后的尿流改道 4、浸润性肿瘤的新辅助化疗：MVAC方案，若结合髂内动脉埋泵化疗效果更佳 （三）膀胱肿瘤术后的随访 术后每周一次膀胱灌注化疗共8次，后改每月一次，总共持续1年。 术后每3个月复查膀胱镜。 Company Logo Company Logo Company Logo Company Logo Company Logo Company Logo Company Logo neurofibroma capillary hemangioma dermoid cyst sebaceous cyst epidermoid cyst thyroid adenoma papillary thyroid carcinoma Company Logo Company Logo 治疗：乳房纤维腺瘤虽属良性，但亦有恶变可能，一经发现，应予手