同步报告病例3（第五回）：一个家庭护理失败的案例，并“夹生足”的同步治疗经过

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15 10月 2019

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Author : 伤口世界

原创：十六点五中山二院糖尿病足中心

经过近两周的治疗

患者的局部情况得到良好的控制

肿胀的左足基本恢复

各个伤口的可见的腐肉已经完全清除

按照我们的治疗流程

患者可以考虑加装负压

出院修养

但患者为夹生足

一些小的脓肿无法完全确定是否已经闭合

同时患者为单身

在这种情况下无法良好的照顾自己

（糖尿病足的院外护理是一个非常大的难题

由于患者无法生活自理

一定需要家人或他人照顾

如果护理不得当

又会出现反复

而多次的反复的结果

就是夹生脚而最终需要截肢

截肢之后更需要良好的照护

如此恶性循环

也是造成糖尿病足难以治愈和控制的重要原因）

为了防治患者病情反复

我们准备转入下级医院

进行有关伤口护理

及糖尿病血糖控制、重要脏器维护的治疗

患者2018年12月5日的情况。

到2018年12月9日时的情况

我们再三叮嘱接收的医院

要继续我们的治疗方式和理念

对于创面的消毒和换药一定要到位

全身抗生素需要再应用2-4周

并密切与我们联系

利用微信每日或隔日

将患者伤口的情况发给我们

以判断是否需要进一步跟进。

由于糖尿病足恢复的缓慢

“同步病例”只能间断刊出

希望大家有足够的耐心

不舍不弃

陪伴着这些病人逐步康复

借用“网红”的语言精确地

反映我们对于糖尿病足病人的情怀：

陪伴是最长情的告白

厮守是最寂寞的等待

默契是最无声的情话

思念是最温情的守候

放手是最痛苦的无奈

回忆是最绵长的忧伤

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Summary

Introduction

Paratesticular sarcoma is an aggressive malignant tumor of mesenchymal origin. The rhabdo-myosarcoma is the most common among children. Rhabdomyosarcoma treatment consists of surgery, chemotherapy and radiotherapy. Prognosic depends on local recurrence and distant metastasis.

Material and methods

We present the case of a 16-year-old male, who in April 2016 underwent right radical orchiectomy surgery by testicular mass rapidly evolving, with pathological results indicating a paratesticular rhabdomyosarcoma. The extension study showed a precaval adenopathy suggestive of lymph node metastasis, therefore it was a high-grade rhabdomyosarcoma. There was an appropriate response after chemotherapy (Protocol EpSSG RMS2005) and we decided to perform a robotic.

Results

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Conclusions

Robotic lymph node metastasis lymphadenectomy from paratesticular sarcomas is a feasible treatment with the advantage of minimally invasive surgery and acceptable morbidity.

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长