nykek5i 发表于 2024-6-24 17:13:28

晚期结直肠癌就不可做手术了吗?


    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">经常有读者问我结直肠癌不做手术行不行?</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span>今天我有必要说一下结直肠癌手术的指征。</p>
    <div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic1.zhimg.com/80/v2-94ec9847201ec8a0d1b39ea6108ac3d8_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">医学发展到今天,癌症仍然是<span style="color: black;">无</span>完全<span style="color: black;">解决</span>的的<span style="color: black;">困难</span>,<span style="color: black;">日前</span>治疗癌症的<span style="color: black;">办法</span>有<span style="color: black;">非常多</span>种,手术、化疗、放疗、免疫治疗、中医中药治疗等等。这些治疗<span style="color: black;">办法</span>中最有效的还是手术治疗,<span style="color: black;">或</span>手术后再化疗、放疗、免疫治疗。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span><span style="color: black;">针对</span>中<span style="color: black;">初期</span>的结直肠癌<span style="color: black;">病人</span>我的<span style="color: black;">意见</span>是<span style="color: black;">即时</span>手术治疗,再<span style="color: black;">按照</span>病理<span style="color: black;">或</span>基因检测来决定<span style="color: black;">是不是</span>接受化疗。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">由于</span><span style="color: black;">初期</span>结直肠癌<span style="color: black;">病人</span>,手术后5年<span style="color: black;">存活</span>率最低<span style="color: black;">亦</span>达到85%以上,<span style="color: black;">实质</span>比这个还高,手术效果很确切,<span style="color: black;">日前</span><span style="color: black;">无</span>哪个<span style="color: black;">办法</span>能比手术治疗效果更好。我是绝对反对中<span style="color: black;">初期</span>结直肠癌<span style="color: black;">病人</span>不做手术,而是<span style="color: black;">经过</span>什么食疗<span style="color: black;">或</span><span style="color: black;">护理</span>来治疗的,这<span style="color: black;">没</span>疑是抱着火药桶往火场里冲。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">社会上<span style="color: black;">尤其</span>是头上经常看到有人说,癌症病人做手术后<span style="color: black;">火速</span>就死了,没做手术的在某某老中医那里拿药吃,反而活了十<span style="color: black;">数年</span>。这种网上医托的言辞<span style="color: black;">非常多</span>人<span style="color: black;">亦</span>相信,可能是<span style="color: black;">由于</span><span style="color: black;">晓得</span>自己患癌症时日不多了,就当救命稻草,抱着试一试的态度。但有的人是听说手术对身体<span style="color: black;">损伤</span>大,而食疗<span style="color: black;">或</span>中医中药对身体<span style="color: black;">损伤</span>小而拒绝做手术,这种<span style="color: black;">状况</span>就很悲哀了。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">不是<span style="color: black;">由于</span>我是外科<span style="color: black;">大夫</span>为了自己的利益才这么<span style="color: black;">意见</span>的,<span style="color: black;">咱们</span>将近一半的手术<span style="color: black;">病人</span>是<span style="color: black;">经过</span>中医科,消化内科、肿瘤内科转过来的,<span style="color: black;">她们</span>都是非手术科室,<span style="color: black;">倘若</span><span style="color: black;">她们</span>有更好的办法还会转病人过来吗?</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当然了有上面想法的<span style="color: black;">病人</span>只是<span style="color: black;">少许</span>,大部分<span style="color: black;">病人</span>还是能听<span style="color: black;">大夫</span>的<span style="color: black;">意见</span><span style="color: black;">即时</span>手术治疗的,对手术治疗<span style="color: black;">亦</span><span style="color: black;">特别有</span><span style="color: black;">自信心</span>,<span style="color: black;">无</span>什么大的异议。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">那<span style="color: black;">倘若</span>是结直肠癌晚期还能<span style="color: black;">不可</span>做手术呢?</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">做手术的目的有:1、治病2、减轻<span style="color: black;">病人</span>痛苦,<span style="color: black;">加强</span>生活质量</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">只要能满足上面两个中的一个就<span style="color: black;">能够</span>做手术了。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">晚期结直肠癌,肿瘤细胞已<span style="color: black;">显现</span>其他器官的转移,<span style="color: black;">例如</span>腹膜、肝脏、肺部、骨头、大脑,肿瘤细胞在这些器官上形<span style="color: black;">成为了</span>单发<span style="color: black;">或</span>多发的肿瘤结节。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这种<span style="color: black;">状况</span><span style="color: black;">通常</span>是不<span style="color: black;">意见</span>手术的,<span style="color: black;">由于</span>手术很难完全将肿瘤完全切除,<span style="color: black;">尤其</span>是在其他器官有多发的肿瘤结节,可能<span style="color: black;">必须</span>把器官的大部分都切掉<span style="color: black;">才可</span>完全切除肿瘤,但这种<span style="color: black;">办法</span>对病人的<span style="color: black;">损伤</span>太大了,病人能<span style="color: black;">不可</span>下手术台都难说,能下来<span style="color: black;">亦</span>会因创伤太大手术后身体体抗力下降,<span style="color: black;">无</span>免疫力的约束,身体里残存的癌细胞会<span style="color: black;">快速</span>增殖,在手术后两三个月就复发了。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但并不是说有远处转移就<span style="color: black;">不可</span>手术了,只要满足以下<span style="color: black;">前提</span>是<span style="color: black;">能够</span>手术的。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">❶远处器官<span style="color: black;">仅有</span>一个或两个孤立的转移肿瘤结节。<span style="color: black;">所有</span>切除肿瘤对器官的创伤比较小,不影响到正常生理功能,身体还<span style="color: black;">能够</span>承受。<span style="color: black;">况且</span><span style="color: black;">按照</span>临床<span style="color: black;">科研</span><span style="color: black;">发掘</span>,这种<span style="color: black;">状况</span>手术切除肿瘤后再化疗,比单纯的化疗不做手术能<span style="color: black;">明显</span><span style="color: black;">加强</span><span style="color: black;">存活</span>率。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">❷<span style="color: black;">本来</span>有多发转移灶,但经过保守治疗后远处的多发肿瘤缩小消失,<span style="color: black;">或</span>减少到一两个。这种<span style="color: black;">状况</span><span style="color: black;">能够</span><span style="color: black;">经过</span>手术把结直肠上的肿瘤切除掉的<span style="color: black;">同期</span>,<span style="color: black;">亦</span>把转移部位的肿瘤<span style="color: black;">一块</span>切除。转移肿瘤个数变少后,手术对肿瘤所在的器官创伤减少,本来<span style="color: black;">已然</span><span style="color: black;">无</span>手术机会,经过放化疗<span style="color: black;">或</span>其他保守治疗后又有手术机会。这种案例经<span style="color: black;">平常</span>到,<span style="color: black;">因此</span>即使是晚期结直肠癌的<span style="color: black;">病人</span><span style="color: black;">亦</span>不要灰心。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">❸因肿瘤向肠腔内生长<span style="color: black;">或</span>肿瘤的压迫使肠道狭窄<span style="color: black;">显现</span>肠梗阻。这种<span style="color: black;">状况</span><span style="color: black;">没</span>论是<span style="color: black;">初期</span>还是晚期都是绝对的手术适应症,对胃肠道<span style="color: black;">病人</span>都适用。即使是晚期结直肠癌<span style="color: black;">亦</span>不是说两三个月人就不行了,<span style="color: black;">非常多</span>人都还能活半年<span style="color: black;">乃至</span>两三年。这么<span style="color: black;">长期</span>肠道梗阻病人会非常痛苦,吃不下东西,肚子胀、肚子痛,<span style="color: black;">乃至</span>肠道粘膜破坏,细菌入血<span style="color: black;">导致</span>全身感染而<span style="color: black;">导致</span>感染性休克<span style="color: black;">或</span>败血症等,这非常致命。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span>只要<span style="color: black;">显现</span>肠梗阻,除非病人<span style="color: black;">通常</span><span style="color: black;">状况</span>很差,做</p>




情迷布拉格 发表于 2024-9-1 21:16:21

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一看到楼主的气势,我就觉得楼主同在社区里灌水。

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