胃癌腹腔转移所致恶性肠梗阻的诊治及营养支持策略.pdfVIP

中国肿瘤临床 2014年第41卷第12期 Chin J Clin Oncol 2014, Vol. 41, No. 12 张岂凡 主任医师，教授，博士生导师。哈尔滨医科大学附属第四医院肿瘤中心主 任。享受国务院特殊津贴。现任中国抗癌协会副理事长。主要从事消化道肿瘤及乳腺 肿瘤的临床综合治疗，尤其是胃癌的综合治疗，并对胃癌的生物学特点、淋巴转移规律及 影响淋巴转移的临床病理因素进行了深入的研究。主持国家级及省级课题10余项。国 内外期刊发表文章 100余篇，其中SCI收录12篇。获国家及省级科技进步奖及新技术成 果奖10余项。 ·特约综述· 作者单位：哈尔滨医科大学附属第四医院肿瘤外科（哈尔滨市150001） 通信作者：张岂凡 qifanzhang01@163.com 胃癌腹腔转移所致恶性肠梗阻的诊治及营养支持策略 张岂凡 郑宏群 孙凌宇 摘要 我国是胃癌发病率较高的国家之一，年新发病例占世界总数的42%，发病特点以进展期胃癌占大多数，复发转移率 高，预后差。恶性肠梗阻是胃癌腹腔转移患者的主要临床表现之一，由于对其认知度不高，治疗水平参差不齐，许多患者未能得 到有效的诊断和治疗，承受巨大的痛苦和精神压力。近年来，随着生长抑素等药物的应用，使得更多胃癌腹腔转移所致恶性肠梗 阻患者的症状得到了有效的缓解，部分患者获得了化疗等抗肿瘤治疗的机会，延长了生存时间。本文就胃癌腹腔转移所致恶性 肠梗阻的诊治进展及营养支持策略进行综述。 关键词 恶性肠梗阻 胃癌 诊断 治疗 doi:10.3969/j.issn.1000-8179Diagnosis, treatment, and nutritional support strategy of malignant bowel obstruction induced by peritoneal metastasis of gastric cancer Qifan ZHANG, Hongqun ZHENG, Lingyu SUN Correspondence to: Qifan ZHANG; E-mail: qifanzhang01@163.com Department of Surgical Oncology, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China Abstract Gastric cancer is one of the most common types of cancer worldwide. In China, approximately 42% of new cancer cas- es are documented. However, the prognosis of advanced gastric cancer remains poor because of high recurrence and metastatic rates. In gastric cancer patients with peritoneal metastasis, malignant bowel obstruction (MBO) is often detected. Many of these patients endure excruciating pain because of ineffective diagnosis and treatment. In recent years, the symptoms of many patients with MBO have been effectively relieved after somatostatin and other drugs have been administered. Other patients with MBO have been provided the chance to undergo chemotherapy, and their survival time has been prolonged. Hence, the diagnosis and treatment of these patients could be im- proved by further advancements in basic and clinical research in cancer therapy. Keywords: malignant bowel obstruction, gastric cancer, diagnosis, treatment 胃癌属世界范围常见恶性肿瘤，年新发病例