五官科小讲课4喉癌课件

“上海市第一人民医院”Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.喉癌9F五官科吴霏霏五官科小讲课Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科概述辅助检查临床表现病理病因定义护理治疗Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科喉的解剖图Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科定义喉癌：是来源于喉粘膜上皮组织的恶性肿瘤，是喉部最常见的恶性肿瘤。1.分布：城市高于农村；重污染地区高于轻污染地区2.发病情况：占全身恶性肿瘤5.7－7.6%,占耳鼻咽喉恶性肿瘤7.9－35%。3.性别：男：女＝1.9－6.8∶14.年龄：高发于50－70岁发病率有日益增多的趋势Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科病因1、抽烟2、饮酒3、空气污染4、职业因素5、病毒感染6、性激素7、癌前病变喉白班喉角化症Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科分型1.声门上型2.声门型3.声门下型4.跨声门型特点60%30%6%分化差发展快转移早分化好发展慢转移晚介于上两型之间发展慢，病程长大小形态：菜花型、结节型、溃疡型、包块型。Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科临床表现分型发生部位早期症状晚期症状病变声门上癌会厌喉面根部痒感，异物感，吞咽不适呼吸困难，吞咽困难，咳嗽，痰中带血或咳血等易向颈内静脉上组淋巴结转移声门癌声带前、中1/3交界处发音易倦或声嘶严重声嘶或失声，放射性耳痛，呼吸困难，吞咽困难，咳嗽频繁，咳痰困难，口臭等颈淋巴结转移率低声门下癌声带平面以下，环状软骨下缘以上部位无症状刺激性咳嗽，声嘶，咯血，呼吸困难等常发生气管前、气管旁淋巴结转移跨声门癌喉室深部声嘶咽喉痛，呼吸困难等易发生淋巴结转移Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科声嘶、痰血01临床表现异物感或疼痛02呼吸、吞咽困难03颈部包块、远隔转移症状04Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科喉癌Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科活检喉镜检查触诊：颈部检查X线、MRICT、PET-CT颈部超声13456辅助检查2Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科二、放疗一、手术治疗三、化疗四、综合治疗治疗Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科手术方式支撑喉镜下切除术全喉切除术适用于晚期喉癌。适用于喉原位癌或较轻的浸润性病变。目前喉激光手术和等离子手术开展逐渐推广，具有微创、出血少、肿瘤播散率低、保留发声功能良好等优点。主要适合较早期病例。包括喉显微二氧化碳激光；喉裂开声带切除术；喉额前部分切除术；垂直、水平半喉切除术；还有一些相应的术式改良，根据声门癌侵犯范围选择。适用于早、中期和部分晚期喉癌。Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科两种常用手术方式的区别部分喉切除术全喉切除术适应症早期声门癌及声门上癌，肿瘤局限在一侧声带T3、T4期喉癌，原发声门下癌，喉部分切或放疗后复发范围一侧喉室，声带舌骨和全部喉结构并发症伤口感染，肺部感染，喉室囊肿咽瘘，器官造瘘口狭窄，伤口感染术后疗效易复发存活率高术后拔管可拔管不拔管或拔管后做发音重建或气管造瘘术术后发音保留原发音功能需发音重建Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科放射治疗：单纯放疗：适用于早期喉癌；全身情况差不宜手术者；晚期肿瘤不宜手术者。术前放疗：适用于肿瘤超出常规切除范围。放疗后可局限肿瘤，使其缩小，间隔2~4周后方可进行手术。术后放疗：适用于对复发肿瘤或发现有远处转移的病人。可降低复发率，控制远处转移的情况发生。Throughthispublicitycampaign,furtherimprovethesenseofbusinessintegrityoftourismenterprisestohelptourismconsumersandoperatorstosafeguardthelegitimaterightsandinterests,toensurethatourCity'stourismsustainable,healthyandcoordinatedDevelopment.上海市第一人民医院五官科化学治疗诱导疗法：PE方案适用于手术或放疗前所采用的化学疗法。靶向治疗：西妥昔单抗适用于手术或放疗后所采用的化学疗法。Throughthispublicitycampaign