{"id":111271,"date":"2019-05-18T00:00:50","date_gmt":"2019-05-20T01:20:27","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/111271\/"},"modified":"2019-05-20T09:20:30","modified_gmt":"2019-05-20T01:20:30","slug":"fbc6668f17","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/111271\/","title":{"rendered":"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 \u9a6c\u6765\u9178\u5421\u54af\u66ff\u5c3c\u7247\u672f\u524d\u4e09\u836f\u8054\u5408\u6cbb\u7597\u4e73\u817a\u764c\u7684\u4e34\u5e8a\u7814\u7a76"},"content":{"rendered":"
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\u70b9\u51fb\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011<\/span><\/strong><\/strong><\/strong><\/span><\/strong><\/strong><\/strong><\/strong><\/span>\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011<\/span><\/strong><\/strong><\/strong><\/strong><\/span><\/strong>\u9a6c\u4e0a\u5165\u7ec4\u4e34\u5e8a\u8bd5\u9a8c<\/span><\/strong><\/span><\/p>\n

\u516c\u4f17\u53f7\uff1ashiyan589<\/span><\/p>\n

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\u6297\u764c\u6307\u5357\u70b9\u51fb\u4e0b\u65b9<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u2193\u2193\u2193<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011<\/a><\/section>\n<\/section>\n<\/section>\n
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\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011<\/a><\/section>\n<\/section>\n<\/section>\n
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\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011<\/a><\/p>\n<\/section>\n

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\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011<\/a><\/p>\n<\/section>\n

\u5165\u7ec4\u62a5\u540d\u65b9\u5f0f\u89c1\u6587\u672b<\/span><\/strong><\/p>\n

\u2193<\/span><\/strong>\u2193<\/span><\/strong>\u2193<\/span><\/strong>\u2193<\/span><\/strong><\/span><\/strong><\/p>\n<\/section>\n<\/section>\n

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\u8bd5\u9a8c\u540d\u79f0<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

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\u5421\u54af\u66ff\u5c3c\u8054\u5408\u8d6b\u8d5b\u6c40\u52a0\u591a\u897f\u4ed6\u8d5b\u5bf9\u6bd4\u5b89\u6170\u5242\u8054\u5408\u8d6b\u8d5b\u6c40\u52a0\u591a\u897f\u4ed6\u8d5b\u672f\u524d\u6cbb\u7597HER2\u9633\u6027\u4e73\u817a\u764c\u7684\u7814\u7a76<\/p>\n


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\u672c\u8bd5\u9a8c\u9002\u5e94\u75c7<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

<\/section>\n<\/section>\n<\/section>\n
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\u65e9\u671f\u6216\u5c40\u90e8\u665a\u671fHER2\u9633\u6027\u4e73\u817a\u764c     <\/span>
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\u8bd5\u9a8c\u836f\u7269<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

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\u9a6c\u6765\u9178\u5421\u54af\u66ff\u5c3c\u7247    <\/span>
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<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8bd5\u9a8c\u72b6\u6001<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

<\/section>\n<\/section>\n<\/section>\n
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 \u8fdb\u884c\u4e2d (\u62db\u52df\u4e2d)   <\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8bd5\u9a8c\u76ee\u7684<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

<\/section>\n<\/section>\n<\/section>\n
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\u6839\u636e\u72ec\u7acb\u8bc4\u5ba1\u59d4\u5458\u4f1a\uff08IRC\uff09\u901a\u8fc7\u75c5\u7406\u5b66\u8bc4\u4f30\u7684tpCR\uff08ypT0\/is\u3001ypN0\uff09\uff0c\u8bc4\u4f30\u5421\u54af\u66ff\u5c3c\u8054\u5408\u66f2\u59a5\u73e0\u5355\u6297\u52a0\u591a\u897f\u4ed6\u8d5b\u76f8\u5bf9\u6bd4\u5b89\u6170\u5242\u8054\u5408\u66f2\u59a5\u73e0\u5355\u6297\u52a0\u591a\u897f\u4ed6\u8d5b\u624b\u672f\u524d\u6cbb\u7597\u65e9\u671f\u6216\u5c40\u90e8\u665a\u671fHER2\u9633\u6027\u521d\u6cbb\u4e73\u817a\u764c\u7684\u7597\u6548\u3002<\/p>\n


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\u8bd5\u9a8c\u8bbe\u8ba1<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

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\u8bd5\u9a8c\u5206\u7c7b<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u5b89\u5168\u6027\u548c\u6709\u6548\u6027 <\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u8bd5\u9a8c\u5206\u671f<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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III\u671f  <\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u8bbe\u8ba1\u7c7b\u578b<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u5e73\u884c\u5206\u7ec4 <\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u968f\u673a\u5316<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u968f\u673a\u5316<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u76f2\u6cd5<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u53cc\u76f2 <\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u8bd5\u9a8c\u8303\u56f4<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u56fd\u5185\u8bd5\u9a8c <\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5165\u9009\u6807\u51c6<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

<\/section>\n<\/section>\n<\/section>\n
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1. \u5e74\u9f84\u226518\u5c81\uff0c\u4e14\u226475\u5c81\u7684\u5973\u6027\u521d\u6cbb\u60a3\u8005\uff1b<\/p>\n

2. ECOG \u8bc4\u52060\uff5e1\u7ea7\uff1b<\/span><\/p>\n

3. \u4e73\u817a\u764c\u7b26\u5408\u4e0b\u5217\u6807\u51c6\uff1a –\u7ec4\u7ec7\u5b66\u786e\u8bc1\u7684\u6d78\u6da6\u6027\u4e73\u817a\u764c\uff0c\u7814\u7a76\u4e2d\u5fc3\u7ecf\u6807\u51c6\u8bc4\u4f30\u65b9\u6cd5\u6d4b\u5b9a\u7684\u539f\u53d1\u80bf\u7624\u76f4\u5f84> 2 cm –\u80bf\u7624\u5206\u671f\uff1a\u65e9\u671f\uff08T2-3\u3001N0-1\u3001M0\uff09\u6216\u5c40\u90e8\u665a\u671f\uff08T2-3\u3001N2\u6216N3\u3001M0\uff09\uff1b<\/span><\/p>\n

4. \u75c5\u7406\u68c0\u6d4b\u8bc1\u5b9e\u7684HER2\u8868\u8fbe\u9633\u6027\u4e73\u817a\u764c\uff0c\u5b9a\u4e49\u4e3a >10%\u514d\u75ab\u53cd\u5e94\u7ec6\u80de\u7684\u514d\u75ab\u7ec4\u7ec7\u5316\u5b66\uff08IHC\uff09\u5206\u6570\u4e3a 3+\u6216\u539f\u4f4d\u6742\u4ea4\uff08ISH\uff09\u7ed3\u679c\u4e3a HER2\u57fa\u56e0\u6269\u589e\uff08HER2 \u57fa\u56e0\u4fe1\u53f7\u4e0e\u7740\u4e1d\u7c92 17\u4fe1\u53f7\u4e4b\u6bd4\u2265 2.0\u6216HER2\u57fa\u56e0\u62f7\u8d1d\u6570\u22656\uff09\uff1b<\/span><\/p>\n

5. \u5df2\u77e5\u6fc0\u7d20\u53d7\u4f53\u72b6\u6001\uff08ER\u548cPgR\uff09\uff1b<\/span><\/p>\n

6. \u4e3b\u8981\u5668\u5b98\u7684\u529f\u80fd\u6c34\u5e73\u5fc5\u987b\u7b26\u5408\u4e0b\u5217\u8981\u6c42\uff08\u7b5b\u9009\u524d2\u5468\u5185\u672a\u8f93\u8840\uff0c\u672a\u4f7f\u7528\u8fc7\u5347\u767d\u7ec6\u80de\u3001\u5347\u8840\u5c0f\u677f\u836f\u7269\uff09\uff1a 1\uff09\u8840\u5e38\u89c4 \uff1f\u4e2d\u6027\u7c92\u7ec6\u80de\uff08ANC\uff09\u22651.5\u00d7109\/L\uff1b \uff1f\u8840\u5c0f\u677f\u8ba1\u6570\uff08PLT\uff09\u226590\u00d7109\/L\uff1b \uff1f\u8840\u7ea2\u86cb\u767d\uff08Hb\uff09\u226590 g\/L\uff1b 2\uff09\u8840\u751f\u5316 \uff1f\u603b\u80c6\u7ea2\u7d20\uff08TBIL\uff09\u2264\u6b63\u5e38\u503c\u4e0a\u9650\uff08ULN\uff09\uff1b \uff1f\u4e19\u6c28\u9178\u6c28\u57fa\u8f6c\u79fb\u9176\uff08ALT\uff09\u548c\u5929\u95e8\u51ac\u6c28\u9178\u6c28\u57fa\u8f6c\u79fb\u9176\uff08AST\uff09\u22641.5\u00d7ULN\uff1b \uff1f\u78b1\u6027\u78f7\u9178\u9176\u22642.5\u00d7ULN\uff1b \uff1f\u5c3f\u7d20\u6c2e\uff08BUN\uff09\u548c\u808c\u9150\uff08Cr\uff09\u22641.5\u00d7ULN\uff1b 3\uff09\u5fc3\u810f\u5f69\u8d85 \uff1f\u5de6\u5ba4\u5c04\u8840\u5206\u6570\uff08LVEF\uff09\u226555%\uff1b 4\uff0912\u5bfc\u8054\u5fc3\u7535\u56fe \uff1fFridericia\u6cd5\u6821\u6b63\u7684QT\u95f4\u671f\uff08QTcF\uff09< 470 msec\uff1b<\/span><\/p>\n

7. \u5bf9\u672a\u7edd\u7ecf\u6216\u672a\u884c\u624b\u672f\u7edd\u80b2\u7684\u5973\u6027\u60a3\u8005\uff1a\u5728\u6cbb\u7597\u671f\u95f4\u548c\u7814\u7a76\u6cbb\u7597\u4e2d\u6700\u540e\u4e00\u6b21\u7ed9\u836f\u540e\u81f3\u5c11  7 \u4e2a\u6708\u5185\uff0c\u540c\u610f\u7981\u6b32\u6216\u4f7f\u7528\u6709\u6548\u7684\u907f\u5b55\u65b9\u6cd5\uff1b<\/span><\/p>\n

8. \u81ea\u613f\u52a0\u5165\u672c\u7814\u7a76\uff0c\u7b7e\u7f72\u77e5\u60c5\u540c\u610f\u4e66\uff0c\u6709\u826f\u597d\u7684\u4f9d\u4ece\u6027\u5e76\u613f\u610f\u914d\u5408\u968f\u8bbf\u3002     <\/span><\/p>\n


<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u6392\u9664\u6807\u51c6<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

<\/section>\n<\/section>\n<\/section>\n
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1. IV\u671f\uff08\u8f6c\u79fb\u6027\uff09\u4e73\u817a\u764c\uff1b<\/p>\n

2. \u708e\u6027\u4e73\u817a\u764c\uff1b<\/span><\/p>\n

3. \u65e2\u5f80\u56e0\u4efb\u4f55\u6076\u6027\u80bf\u7624\u63a5\u53d7\u8fc7\u6297\u80bf\u7624\u6cbb\u7597\u6216\u653e\u5c04\u7597\u6cd5\uff0c\u4e0d\u5305\u62ec\u5df2\u6cbb\u6108\u7684\u5bab\u9888\u539f\u4f4d\u764c\u3001\u57fa\u5e95\u7ec6\u80de\u764c\u6216\u9cde\u764c\u7b49\u6076\u6027\u80bf\u7624\uff1b<\/span><\/p>\n

4. \u540c\u65f6\u5728\u5176\u4ed6\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u63a5\u53d7\u6297\u80bf\u7624\u7597\u6cd5\uff0c\u5305\u62ec\u5185\u5206\u6ccc\u7597\u6cd5\u3001\u53cc\u78f7\u9178\u76d0\u7c7b\u7597\u6cd5\u6216\u514d\u75ab\u7597\u6cd5\uff1b<\/span><\/p>\n

5. \u5728\u968f\u673a\u5316\u524d4\u5468\u5185\u63a5\u53d7\u8fc7\u91cd\u5927\u4e0e\u4e73\u817a\u764c\u65e0\u5173\u7684\u624b\u672f\u64cd\u4f5c\uff0c\u6216\u60a3\u8005\u5c1a\u672a\u4ece\u6b64\u7c7b\u624b\u672f\u64cd\u4f5c\u4e2d\u5b8c\u5168\u6062\u590d\uff1b<\/span><\/p>\n

6. \u4e25\u91cd\u5fc3\u810f\u75be\u75c5\u6216\u4e0d\u9002\uff0c\u5305\u62ec\u4f46\u4e0d\u9650\u4e8e\u4e0b\u5217\u75be\u75c5\uff1a –\u5fc3\u529b\u8870\u7aed\u6216\u6536\u7f29\u529f\u80fd\u969c\u788d(LVEF < 50%)\u786e\u8bca\u53f2 –\u9ad8\u98ce\u9669\u672a\u63a7\u5236\u7684\u5fc3\u5f8b\u5931\u5e38\uff0c\u5982\u623f\u6027\u5fc3\u52a8\u8fc7\u901f\uff0c\u9759\u606f\u5fc3\u7387> 100 bpm\uff0c\u663e\u8457\u5ba4\u6027\u5fc3\u5f8b\u5931\u5e38\uff08\u5982\u5ba4\u6027\u5fc3\u52a8\u8fc7\u901f\uff09\u6216\u8f83\u9ad8\u7ea7\u522b\u7684\u623f\u5ba4\u4f20\u5bfc\u963b\u6ede\uff08\u5373 Mobitz II\u4e8c\u5ea6\u623f\u5ba4\u4f20\u5bfc\u963b\u6ede\u6216\u4e09\u5ea6\u623f\u5ba4\u4f20\u5bfc\u963b\u6ede\uff09 –\u9700\u8981\u6297\u5fc3\u7ede\u75db\u836f\u7269\u6cbb\u7597\u7684\u5fc3\u7ede\u75db  –\u5177\u6709\u4e34\u5e8a\u610f\u4e49\u7684\u5fc3\u810f\u74e3\u819c\u75c5  –ECG\u663e\u793a\u6709\u900f\u58c1\u6027\u5fc3\u808c\u6897\u585e –\u9ad8\u8840\u538b\u63a7\u5236\u4e0d\u4f73\uff08\u6536\u7f29\u538b> 180 mmHg\u548c\/\u6216\u8212\u5f20\u538b> 100 mmHg\uff09\uff1b<\/span><\/p>\n

7. \u65e0\u6cd5\u541e\u54bd\u3001\u80a0\u6897\u963b\u6216\u5b58\u5728\u5f71\u54cd\u836f\u7269\u670d\u7528\u548c\u5438\u6536\u7684\u5176\u4ed6\u56e0\u7d20\uff1b<\/span><\/p>\n

8. \u5df2\u77e5\u5bf9\u672c\u65b9\u6848\u836f\u7269\u7ec4\u5206\u6709\u8fc7\u654f\u53f2\u8005\uff1b\u6709\u514d\u75ab\u7f3a\u9677\u75c5\u53f2\uff0c\u5305\u62ecHIV\u68c0\u6d4b\u9633\u6027\uff0c\u6216\u60a3\u6709\u5176\u4ed6\u83b7\u5f97\u6027\u3001\u5148\u5929\u6027\u514d\u75ab\u7f3a\u9677\u75be\u75c5\uff0c\u6216\u6709\u5668\u5b98\u79fb\u690d\u53f2\uff1b<\/span><\/p>\n

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10. \u60a3\u6709\u6709\u4e25\u91cd\u7684\u4f34\u968f\u75be\u75c5\u6216\u5176\u4ed6\u4f1a\u5e72\u6270\u8ba1\u5212\u6cbb\u7597\u7684\u5408\u5e76\u75be\u75c5\uff0c\u6216\u7814\u7a76\u8005\u8ba4\u4e3a\u60a3\u8005\u4e0d\u9002\u5408\u53c2\u52a0\u672c\u7814\u7a76\u7684\u5176\u4ed6\u4efb\u4f55\u60c5\u51b5\u3002     <\/span><\/p>\n


<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4e3b\u8981\u7814\u7a76\u8005\u4fe1\u606f<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

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\u5434\u7085   \u4e3b\u4efb\u533b\u5e08<\/span>    <\/span><\/p>\n

\u590d\u65e6\u5927\u5b66\u9644\u5c5e\u80bf\u7624\u533b\u9662 <\/span> <\/span>      <\/span><\/p>\n

\u4e0a\u6d77\u5e02\u5f90\u6c47\u533a\u4e1c\u5b89\u8def270\u53f7     <\/span><\/p>\n

 <\/span>     <\/span>
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    <\/p>\n

<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u8bd5\u9a8c\u53c2\u4e0e\u673a\u6784\u4fe1\u606f<\/strong><\/p>\n<\/section>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011 <\/p>\n

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<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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<\/section>\n<\/section>\n<\/section>\n<\/section>\n


<\/p>\n

<\/section>\n

\u626b\u63cf\u4e0b\u65b9\u4e8c\u7ef4\u7801\uff0c\u56de\u590d\u201c\u5165\u7ec4\u201d\u5373\u53ef<\/strong><\/span><\/span><\/p>\n

\u2193<\/strong>\u2193<\/strong>\u2193<\/strong>\u2193<\/strong><\/strong><\/span><\/span><\/p>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011<\/p>\n


<\/p>\n

\"\u3010\u4e73\u817a\u764c-\u60a3\u8005\u62db\u52df\u3011\u70b9\u51fb\u201c<\/span>\u9605\u8bfb\u539f\u6587<\/span>\u201d\u67e5\u770b\u8be6\u60c5<\/span><\/p>\n<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"

\u70b9\u51fb\u9a6c\u4e0a\u5165\u7ec4\u4e34\u5e8a\u8bd5\u9a8c \u516c\u4f17\u53f7\uff1ashiyan589 \u6297\u764c\u6307\u5357\u70b9\u51fb\u4e0b\u65b9 \u2193\u2193\u2193 \u5165\u7ec4\u62a5\u540d\u65b9\u5f0f\u89c1\u6587\u672b \u2193\u2193\u2193\u2193 \u8bd5\u9a8c […]<\/p>\n","protected":false},"author":1,"featured_media":111272,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/111271"}],"collection":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/comments?post=111271"}],"version-history":[{"count":1,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/111271\/revisions"}],"predecessor-version":[{"id":111292,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/111271\/revisions\/111292"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media\/111272"}],"wp:attachment":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media?parent=111271"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/categories?post=111271"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/tags?post=111271"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}