肿瘤学课件 泌尿系统.pptVIP

Treatment- Surgery 治疗－手术 Preferred method of treatment for all tumors located at the apex and benign tumors 对于膀胱顶部的肿瘤及良性肿瘤，手术是首选治疗方案 Up to 75-80% of the bladder can be resected 多达 75-80% 的膀胱可被切除 Techniques: 技术 - Complete or partial cystectomy (ureterocolonic anastomosis - complications!) 膀胱全部或部分切除术（可同时采用输尿管结肠吻合术 ） - CO2 laser ablation 二氧化碳激光消融术 - Transurethral placement of metallic stents 尿道安置金属支架 - Permanent indwelling urethral catheters or cystostomy tubes 长期内置导尿管或膀胱人造导尿管 TCC Treatment- Radiotherapy治疗-放射线疗法 Intraoperative radiation therapy with or without postoperative radiation therapy has been used 手术过程中进行放疗，有时也可术后进行 Ureters or bladder in radiation field = become stenotic and fibrotic = urinary incontinence and secondary renal injury common 放疗中的输尿管或膀胱变得狭窄或纤维变性；并导致尿失禁和肾脏再次损伤； Local tumor control poor 局部肿瘤很难控制 TCC * Tumors of the Urinary System 泌尿系统肿瘤 Susan 苏珊 Signalment 特征 FS, collie mix Fs和牧羊犬的杂交 12 years old 12岁 Presenting complaint 临床表现 Stranguria (barely able to urinate) 痛性尿淋沥（几乎不能排尿） Discolored urine 尿的颜色异常 History 病史 For a few weeks, the owner has noticed stranguria and discolored urine. 几周以来，主人发现苏珊有痛性尿淋沥和尿液颜色异常的现象。 Susan was first slightly better after antibiotic therapy, now the clinical signs are worse again. 起初，在抗生素治疗后情况有所好转，但现在临床症状又恶化了。 She is eating and drinking normally, no c/s/v/d. 其饮食情况正常，无咳嗽/呕吐/拉稀/沉郁等现象。 Physical Exam (Abnormalities)体检（异常） Stranguria multiple times during the exam, a few drops of discolored urine were released with each episode. 检查时发生多次痛性尿淋沥，每次都有几滴变色的尿液排出 Problem List 问题所在 Stranguria 痛性尿淋沥（淋症） Discolored urine 尿色异常 Diagnostic Plan 诊断方案 CBC 血细胞计数 Chemistry panel 生化分析 Urinalysis 尿液分析 Thoracic radiographs 胸部x光照片 Abdominal ultrasound 腹部B超检查 Results-Blood/Urine血液/尿液分析结果 CBC: normal 血细胞计数正常 Chemistry panel: normal 生化分析：正常 Urinalysis: 尿液分析： Specific Gra