胸外科病例討論英文版學(xué)習(xí)課件

1、Case report Case report Chief Complaint: Intermittent cough for 1 year，with bloody sputum 20 daysHistory of present illness: Patient has been cough sputum for about 1 year with no obvious Incentives.His sputum was White foamy sputum and when patient walking fast ,cough was obviously increased whilea

2、s a little rest can be bebefit for cough cutting .These symptoms appear intermittently with no formal diagnosis.Patient coughed bloody sputum 20days ago and a chest CT at local hoapital reported :Left lower lobe mass, consider lung cancer.Chief Complaint:History of prePast medical history: previousl

3、y healthy, no history of tuberculosis and no history of chronic bronchitis, no food, drug allergies, no history of trauma, surgeryPersonal history: smoking 20cigarettes per day with 40years history, drinking Irregular.Obstetrical history: married, sterile a son. Family history: family health, no hep

4、atitis, tuberculosis patients without hypertension, diabetes, non-hereditary disease.Past medical history: previousCT examinationCT examinationCT examinationCT examinationCT examinationCT examinationCT examinationCT examinationCT examinationCT examinationCT examinationCT examinationElectronic bronch

5、oscopy examination左肺下葉可見(jiàn)腔內(nèi)腫物，累及左主支氣管直至距隆突4個(gè)軟骨環(huán)處，管腔部分堵塞 Electronic bronchoscopy examinPathological diagnosisAdenocarcinomaPathological diagnosisAdenocarEGFR gene mutation detectionEGFR gene mutation detectionEGFR gene mutation detectionEGFR gene mutation detectionThe treatment principlesIcotinib 125m

6、g Tid po The treatment principlesIcotinCT examination after two monthsCT examination after two monthCT examination after two monthsCT examination after two monthCT examination after two monthsCT examination after two monthCT examination after two monthsCT examination after two monthCT examination af

7、ter two monthsCT examination after two monthCT examination after two monthsCT examination after two month Contrast Before treatment After treatment Contrast Electronic bronchoscopy examination左肺下葉可見(jiàn)腔內(nèi)腫物，累及左主支氣管直至距隆突7個(gè)軟骨環(huán)處，管腔部分堵塞 Electronic bronchoscopy examin Contrast The treatment principles2. Surg

8、ical operation The surgical indications were performed Left pneumonectomy surgery(2013.08.06) Removal part of esophageal muscularis and part of the pericardium3. Local chemotherapy Refused4.Continue Icotinib treatment The treatment principles2. SurPathological diagnosisModerately differentiated aden

9、ocarcinoma 2*1.5*1.5 Bronchial stump（-）4L(0/2)、5(0/2)、6(0/2)、7(2/10)、8(0/1)、10(1/4) pT3N2M0 APathological diagnosisModerateFollow-upContinuous administration Icotinib and reviewing monthlyWithout local recurrence and metastasisFollow-upContinuous administrConclusionThe advanced administration of tar

10、geted medicine can reduce the risk and difficulty of surgeryConclusionDiscussion1.Targeted medicine mainly be used for patients with locally advanced lung cancer who has been received prior chemotherapy or metastatic non-small cell lung cancer patientsTargeted medicine can be another option of neoadju