Добавил:
Upload Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:
Скачиваний:
26
Добавлен:
27.02.2016
Размер:
69.63 Кб
Скачать

5.2.1. Preparation stage:

At the beginning of class, the instructor introduces students to the basic tasks of occupation plan. To control the output level of knowledge of students each proposed to solve typical issues in diagnosis - you can use situational clinical problem.

5.2.2. Main stage:

Materials for the methods of the main stage sessions

N Abir skenohram, tables, owner of anticancer chemotherapy, hospital records and medical history of patients with precancerous and p ak prostate findings of morphological studies of biopsies of tumors of the prostate (when possible micropreparations)

Polls and physical examination performed with the patient turns the students, under the supervision of the teacher. To evaluate the accuracy of surveys consistently attracted other students.

When patients surveyed students' attention is drawn to the medical history of the disease, the presence of chronic inflammation and precancerous oryuvan illnesses.

When patients surveyed students' attention is drawn to the medical history of the disease, the study of factors that give rise to prostate cancer.

Among malignant diseases in men with prostate cancer is 8-12%. The greatest incidence in Northern Europe and North America (30-50 per 100,000 population) etiology - not fully understood. Etazhn  bind with high content of androgens. Macroscopically, prostate cancer has the form of small units measuring 1 - 1.5 cm, placed under the capsule in the peripheral regions of the prostate. While growth may take the entire gland and move into surrounding tissue.

There are histological forms of prostate cancer:

Adenokartsinoma - 70%

a) tubular (svitloklitynna, temnoklitynna).

b) slyzoutvoryuyucha - 2% krybroznyy cancer - 10%, undifferentiated carcinoma - 16%, squamous cell carcinoma - 2% other.

Tubular adenokartsinoma characterized by a benign course, and slyzoutvoryuyucha krybroznyy cancer unfavorable course.

Early symptoms of prostate cancer is not, is only finger study by prophylactic examinations. In 80% of cases sposteriahyutsya urinary disorders similar to benign prostate. Pain in the perineum, the anus, and buttocks may be caused germination capsule gland.

Metastasis lymphogenous in l / nodes and hematogenous bone in the pelvis and spine.

Palpable gland, which initially may be normal size, then may increase. Unit prostate dense, looks like a cone, facing the tip into the lumen of the rectum. With further growth of prostate tumors in a real infiltrate.

Percutaneous biopsy performed transrektal nym or perineal access. Transrectal ultrasound conducting research. CT is used for 3-4 stage. Lymphography shows in 70-80% of cases of metastatic lymph nodes. 90-95% of patients appear in the later stages and is inoperable. Apply surgery, radiation therapy, hormone-and chemotherapy.

At T 1.2 perform radical prostatectomy with the seminal vesicles, fiber and neck of the bladder (the operation is possible in 5-8% of patients). When N 1 - castration and estrogenoterapii, often used THT. At T 3 conduct remote THT on prostate, castration and estrogenoterapii. At T 4 or M 1 - the same treatment. Estrogenoterapii start with large doses within 1-1,5 months. Then, a maintenance therapy. Sinestrol intramuscularly 80 mg or 500 mg honvanu (fosfestrolu) in / every day.

In hormonorezystentnyh - 10-20% of prostate tumors - used methotrexate, cisplatin, 5-fluorouracil, cyclophosphamide, adriamycin, vinblastine, DTIK. Results from monochemotherapy almost like and from chemotherapy.

Weather. 5-year survival in the early stages after radical surgery - 80% after THT - 80%, hormone therapy - 45-65% in the late stages of the 5-year survival rate - 10-30%.

 

Соседние файлы в папке Преподавателям