摘要
目的:探讨药物、肠外营养支持联合胃肠减压、局部物理疗法等非手术措施治疗恶性肠梗阻的疗效。方法:收集39例恶性肿瘤合并肠梗阻患者进行回顾分析,采取胃肠减压以及奥曲肽、止吐药、止痛药和糖皮质激素等药物,联合肠外营养支持、脐部外贴伤湿解痛膏或麝香壮骨膏结合腹部按摩、体外高频热疗等方法,观察治疗前后梗阻症状的缓解与KPS评分变化的情况。结果:39例患者中,30例完全缓解:治疗结束后临床症状完全消失,X线检查肠管积气、积液消失;5例改善:治疗结束后临床症状及X线检查肠道梗阻征象部分缓解;4例无效:治疗结束后临床症状未消失或加剧,X线检查肠道梗阻征象无改善。治疗后全组病例KPS评分明显升高,P<0.001。39例患者的中位生存期为6个月,1年、2年、3年生存率分别为23.08%、7.69%和5.13%。结论:药物及胃肠减压联合局部处理综合疗法对恶性肿瘤并肠梗阻患者的疗效好,尤其肿瘤治疗相关性梗阻疗效确切,患者生活质量明显改善,不良反应轻,值得推广应用。
Objective：To study the efficacy of non-surgical comprehensive measures including drugs,parenteral nutrition support,gastrointestinal decompression,and local physical therapy for MBO.Methods： Thirty-nine tumor patients complicated with MBO were enrolled in the retrospective study.All the patients received treatment such as gastrointestinal decompression,drugs combined with octreotide,antiemetic,painkillers and glucocorticoid hormone,and parenteral nutrition support,medicinal plaster applied to navel region,abdomen massage,abdominal thermotherapy,therapeutic efficacy of bowel obstruction and KPS score before and after treatment were observed.Results： Of the 39 cases with MBO,30 patients had complete response after the treatment with the clinical symptoms vanishing completely,intestines pneumatosis and product fluid vanishing when X-ray inspection was performed;5 patients had good response with partial remission of clinical symptoms and X-ray examination of bowel obstruction;4 patients were ineffective,with the clinical symptoms and X-ray signs of bowel obstruction without improvement even exacerbation.The KPS score in all cases after treatment was significantly higher,P0.001.The median survival of all cases was 6 months.1,2,and 3-year survival rates were 23.08%,7.69% and 5.13% respectively.Conclusion： The regimen consisting of drugs combined with octreotide,antiemetic,painkillers and glucocorticoid hormone,parenteral nutrition support,gastrointestinal decompression,and local physical therapy including abdomen massage,abdominal thermotherapy and medicinal plaster applied to navel region in tumor patients complicated with MBO especially cancer treatment-related obstruction has a good efficacy and mild side effects,can improve quality of life of patients.
出处
《现代肿瘤医学》
CAS
2012年第2期390-393,共4页
Journal of Modern Oncology
关键词
肿瘤
肠梗阻
药物
胃肠减压
腹部按摩
热疗
tumor
malignant bowel obstruction（MBO）
drugs
gastrointestinal decompression
abdomen massage
thermotherapy
