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Summary: Five -year -old female patients were checked in the chest CT in the outer hospital to find the lung occupation in the body in a foreign hospital. There was usually no other discomfort.In November 2022, a CT examination in a foreign hospital showed that the nodules in the right lungs increased before. Considering the possibility of tumor lesions, it is recommended to check further.So he came to our hospital for consultation. After the patient was admitted to the hospital, the relevant examination was improved. According to the results of the examination, the clinical diagnosis was lung cubic-right lung nodules.So I performed the patient in the right lung of the VATS right lungs+the thoracic lymph nodes cleansing+the lower lobe thoracic adhesion.The pathological tips of the postoperative are primary pulmonary adenocarcinoma.In order to control the patient’s condition, giving chemotherapy drug treatment, anti -tumor, anti -infection and other symptomatic support treatment, and regularly come to the hospital for review.Since the follow -up, the patient has a stable condition and has not seen tumors recur.
【Basic Information】 Female, 52 years old
【Disease Type】 Lung adenocarcinoma
[Consultation Hospital] Jinzhong First People’s Hospital
[Time] November 2022
[Treatment Plan] Surgical treatment (VATS right lung resection+thoracic lymph nodes cleansing+right lung lobe thoracic adhesion)+chemotherapy drugs (Peimev, Card platinum)
[Treatment cycle] 15 days of hospitalization
[Treatment effect] The patient’s surgery is smooth, and the condition can be controlled
1. First diagnosis
Patient’s female, 52 years old, described itself when she was a doctor: 1 year ago in a foreign hospital, she checked the chest CT to find lung occupation.Physical examination shows: special assessment ECOCPS score: 1 point; pain score: 1 point; venous thrombosis (VTE) score: Caprini score: 3 points; nutritional risk scoreThe superficial lymph nodes of the whole body did not touch the swelling, the heart rhythm, the valve areas and the pathological murmur, the thorax has no deformity, the breathing and motion are free, the syntax is symmetrical, the pleural friction is not touched, the two lung percussion, the two lung breathing breathingThe sound was clear, and the sound of the wet and wet Luo Luo was not abnormal, and the lower limbs were not swollen.Auxiliary examination: 2021-12-11 CT examination: 1. The bottom nodules of the middle leaf in the right lung and lower left lung leaves, consider inflammatory granuloma, and recommend the annual clinic.(Compared with 2021-06-23 The lung CT has not changed much); 2. Chronic inflammation of the lower lung lobe, and the left pleura are slightly thickened; 3. The thoracic bone hyperplasia is narrowed and the spinal canal is narrowed horizontally.2022-11-12 CT examination: Comparison of 2021-12-11 CT, the nodule in the right lung increases compared to the previous.1. In the middle of the right lung, the possibility of tumor lesions is considered. It is recommended to check further: 2. Small nodules in the lower lungs, and the nature is to be determined. Please follow the clinic.TH5-6 spinal canal narrowing.In order to further treat our hospital for further treatment, I temporarily admitted to the hospital with “lung occupation lesions”.
After the patient was admitted to the hospital, there was no obvious abnormalities in the blood routine, routine stool, liver and kidney function, coagulation function, admission special examination, tumor marking, and lung function.Pot/CT tumor full -body appearance examination Tips: The accompaniment of the nodules in the right lungs increases, the malignant lesions and the infectious lesions are to be identified. The latter is more likely. It is recommended to spend biopsy at the clinic when necessary.CT CT examination tips: 1. Inner part of the right lung, tumor lesions and infectious lesions are to be identified.The possibility of the latter is high, it is recommended to combine the puncture biopsy for consultation;The comprehensive diagnosis is considered: lung campaign-right lung nodule.The patient’s right lung lobe has surgical indications.The patient and their families have the willingness to surgery, so after arranging the patient to conduct relevant examinations and eliminate absolute surgery taboos, send the operating room at 2022.12.02 to the mid -anesthesia lower VATS right lung resection+thoracic lymph nodes cleansingSurgery, smooth operation, frozen pathology during the operation: (right lung lobe) primary lung adenocarcinoma.The overall surgery went smoothly and returned to the ward after surgery.The postoperative treatment was given to the treatment of acid preservation, expanded bronchial, atomized expectorant, and immune support. The results of postoperative pathology and immunohistochemicals indicated that primary pulmonary adenocarcinoma was required, and subsequent chemotherapy drugs were required.Postoperative adjuvant treatment: Peimev, Card platinum, with an appropriate amount of physiological saline or glucose intravenous injection. The chemotherapy cycle is four cycles, and the week period is 21 days.
Third, treatment effect
The patient’s surgery was smooth, and the postoperative security returned to the ward. The patient recovered well after surgery. The functional exercise was performed on the second day after the operation.After using a cycle of chemotherapy drugs, the patient did not have serious adverse reactions. Occasionally nausea, vomiting and other symptoms occasionally appeared in subsequent chemotherapy treatment. After the patient’s family was disposed of, it had been relieved.There is no phenomenon of bone marrow suppression in the routine of the blood. The patient has completed all cycles of chemotherapy. The lung CT does not indicate the signs of the recurrence and metastasis of the tumor. The prognosis effect is better.
The patient’s surgery was smooth and the postoperative recovery was very relieved. I was very pleased.I was discharged from the patient before discharge of the patient. I told her to continue to pay attention to the postoperative review. I should check the urine routine, blood routine, lactate dehydrogenase, alkaline phosphatase, and chest cleansing CT.Follow the doctor’s order to conduct a regular review to monitor the lungs.The postoperative diet should not be greasy. If there is no adverse reaction of the gastrointestinal tract after surgery, it can transition to semi-current. Ordinary foods can usually eat normally after 3-4 days.Because of the consumption of the disease, patients need to eat high -calorie, high -protein, high -vitamin foods such as eggs, milk, fish, and grains.After discharge, you should pay attention to rehabilitation exercise, but in the short term, you still focus on rest. Movement also needs to be gradual. You must not exercise severely when you come up. You should choose the appropriate exercise method according to your physical condition, such as walking and jogging.Strictly prohibit smoking and drinking in daily life, away from the environment that contains irritating gases.If discomfort symptoms occur, you must follow the clinic in time.Five, personal perception
Lung adenocarcinoma is only a classification of lung cancer. Therefore, after suffering from lung adenocarcinoma, generally treats lung adenocarcinoma according to the treatment of lung cancer. At present, lung adenocarcinoma is mainly based on cure.Chemotherapy, radiotherapy, and targeted drugs and other treatment methods, and if you treat lung adenocarcinoma early, its prognosis is relatively good.With the improvement of diagnostic technology and people’s awareness of medical examinations, the early diagnosis rate has increased. For lung adenocarcinoma, it is best to discover early, early treatment. Generally, people who are greater than 55 years old, and smokers are the most.It is good to perform a low -dose chest CT examination once a year to screen lung adenocarcinoma.When discovering abnormal results, do not make your own claims. You must go to the hospital immediately to obey the professional advice of the doctor, so as to prevent early prevention, early detection, and early treatment of lung adenocarcinoma.