喉科Laryngology溫州醫(yī)科大學(xué)附屬第二醫(yī)院黃賽瑜喉科1Contenis喉乳頭狀瘤>喉癌喉梗阻上氣道阻塞的處理20Contenis2Learningobjectives掌握喉乳頭狀瘤的臨床特點及治療原則掌握喉癌的臨床表現(xiàn)及治療原則掌握氣管切開適應(yīng)證、術(shù)后護理及并發(fā)癥掌握喉梗阻的病因、臨床表現(xiàn)、呼吸困難分度及相應(yīng)的急救措施Learningobjectives3LaryngealTumorsBenign:喉乳頭狀瘤、血管瘤纖維瘤、神經(jīng)纖維Malignant:喉癌LaryngealTumors4民乳頭狀瘤(190)Papillomaoflarynx喉部最常見的良性腫瘤任何年齡均可發(fā)生,10歲以下多見極易復(fù)發(fā),多數(shù)為多發(fā)性隨年齡增長有自限性,成人有癌變可能民乳頭狀瘤(190)5Pathogenesis與乳頭狀瘤病毒(HPV-6,11)有關(guān)由復(fù)層扁平上皮聚集的上皮瘤基底膜完整,單發(fā)或多發(fā)母親尖銳濕疣與兒童乳頭狀瘤的關(guān)系Pathogenesis6Pathology外觀:乳頭狀突起成人一般為單發(fā)兒童廣基、多發(fā)復(fù)層扁平鱗狀上皮·富含血管的結(jié)締組織未侵及基底膜Pathology7ClinicFinding(symptoms)進行性聲嘶喉喘鳴呼吸困難兒童易喉梗阻(腔小,生長快,多發(fā))重者可有吞咽困難ClinicFinding(symptoms)8ClinicFinding(exam)乳頭狀、淡紅或暗紅成人單發(fā),小兒多發(fā)廣基好發(fā):聲門區(qū)多見,其次聲門上及聲門下、甚至氣管其鼻喉ClinicFinding(exam)9Treatment1.手術(shù):顯微支撐喉鏡,喉裂開手術(shù)。注意癌變復(fù)發(fā)傾向。2.激光、等離子切除3.免疫療法:自體疫苗、干擾素、轉(zhuǎn)移因子Treatment10【耳鼻喉臨床課件】喉211【耳鼻喉臨床課件】喉212【耳鼻喉臨床課件】喉213【耳鼻喉臨床課件】喉214【耳鼻喉臨床課件】喉215【耳鼻喉臨床課件】喉216【耳鼻喉臨床課件】喉217【耳鼻喉臨床課件】喉218【耳鼻喉臨床課件】喉219【耳鼻喉臨床課件】喉220【耳鼻喉臨床課件】喉221【耳鼻喉臨床課件】喉222【耳鼻喉臨床課件】喉223【耳鼻喉臨床課件】喉224【耳鼻喉臨床課件】喉225【耳鼻喉臨床課件】喉226【耳鼻喉臨床課件】喉227【耳鼻喉臨床課件】喉228【耳鼻喉臨床課件】喉229【耳鼻喉臨床課件】喉230【耳鼻喉臨床課件】喉231【耳鼻喉臨床課件】喉232【耳鼻喉臨床課件】喉233【耳鼻喉臨床課件】喉234【耳鼻喉臨床課件】喉235【耳鼻喉臨床課件】喉236【耳鼻喉臨床課件】喉237【耳鼻喉臨床課件】喉238【耳鼻喉臨床課件】喉239【耳鼻喉臨床課件】喉240【耳鼻喉臨床課件】喉241【耳鼻喉臨床課件】喉242【耳鼻喉臨床課件】喉243【耳鼻喉臨床課件】喉244【耳鼻喉臨床課件】喉245【耳鼻喉臨床課件】喉246【耳鼻喉臨床課件】喉247【耳鼻喉臨床課件】喉248【耳鼻喉臨床課件】喉249【耳鼻喉臨床課件】喉250【耳鼻喉臨床課件】喉251【耳鼻喉臨床課件】喉252【耳鼻喉臨床課件】喉253【耳鼻喉臨床課件】喉254【耳鼻喉臨床課件】喉255【耳鼻喉臨床課件】喉256【耳鼻喉臨床課件】喉257【耳鼻喉臨床課件】