肺部疾病ppt课件_2.pptVIP

Disorders of Lungs;History;Surgical Procedures;Thoracic Surgeons must DO;Operative Indications;Bronchiectasis(支气管扩张);Clinical Manifestation ;Diagnosis;thin-section high-resolution CT  noninvasive  sensitivity specificity 95% ;Surgical Treatment Indication ;contraindication;Preoperative Preparations;Operative methods;Surgical Treatment of Pulmonary tuberculosis ;Pulmonary resection;Contraindication ;Perioperative Teatment;Complications;Thoracoplasty;Contraindication;method;Lung cancer;Etiology;Pathology;Classification;Metastasis;Clinical manifestation;; 4）pleural effusion  (胸水）5) mediastinium  esophagus(食管)6) pancoast tumor （肺上沟癌） Horner ;Paraneoplastic Syndromes （副癌综合症） ;Diagnosis;;Sputum cytology(细胞学)for central hemoptysisreapeated Bronchoscopyfor centralbiopsy, brushing, washingtransbronchial aspiration(穿刺） Mediastinoscopy  (纵隔镜检查) biopsy for mediastinal lymph node 1cm ;PET/CT（positron emission tomography）increased glucose metabolism sensitivity specificity 95%distinguishing benign from malignant nodulesevaluation of mediastinal LN;Transthoracic needle aspiration(穿刺活检)for peripheral invasivebenign result not exclude malignancyIndication: 1)poor candidate for thoracotomy yet  require definitive diagnosis  2)suggestive SCLC Complication : pneumothorax(气胸) ，hemothorax(血胸) infection;Biopsy of metastasis lesion supraclavicular(锁骨上) cervical(颈部) axil(腋部) subcutaneous(皮下) LN nodule Pleural effusion cancer cell Thoracotomy thoracoscopy undetermined diogniosis staging ;Revised definition of TNM;T3 Tumor of any size that directly invades any of the following: chest wall , diaphragm, mediastinal pleura, pericardium; or tumor in the main bronchus less than 2 cm distal to the carina, but without involvement of the carina; or associated atelectasis（肺膨胀不全） or obstructive pneumonitis（肺炎） of the entire lung ;;Regional Lymph Nodes (N) NX Regional lymph nodes cannot be assessed N0 No