再说低位直肠癌的保肛
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/RsJTOV0EsPkW8PTRSKOia7ymdUtYAf4Syu5lyYr1YntOI5L6vDWGjJzTf67QNJX1ic84Ve6GKjzVCefZ10icmNCgw/640?wx_fmt=gif&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/RsJTOV0EsPkW8PTRSKOia7ymdUtYAf4Syo1vX7tiaWRz6sZcBPZXcFPBWkC4qw2HOZvMEibic2tHDk1qiaicmv7A5uHw/640?wx_fmt=gif&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkW8PTRSKOia7ymdUtYAf4SyLNthrhnlvnO1TWs8CRQZeib3OAUEKWo3Cluxeic9qgoXqucII4O0sDWQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 今天又有两名</span><strong style="color: blue;"><span style="color: black;">超低位（距肛缘4厘米）</span></strong><span style="color: black;">直肠癌<span style="color: black;">病人</span>保肛手术后顺利出院，低位保肛手术<span style="color: black;">优良</span>颇多，既满足了<span style="color: black;">病人</span><span style="color: black;">保存</span>肛门的迫切需求，<span style="color: black;">加强</span>生活质量，又不<span style="color: black;">增多</span>术后肿瘤复发率。本文就下列问题逐一介绍，<span style="color: black;">期盼</span>能够减轻广大<span style="color: black;">病人</span>的心理<span style="color: black;">包袱</span>，减轻身心痛苦。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPmdN31ciaHrftavIMQH5W0tlP7Vh90EYRMnRvo5GZmfppmyUPSiaMVElRYt1DW6sOyQsFR1n5DdbuLQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;"> 什么是直肠癌？</span><span style="color: black;">什么是直肠？什么是大肠癌？</span><span style="color: black;">直肠癌怎么治疗？<span style="color: black;">怎样</span>分期？放疗的适应症？化疗的原则？保肛的利<span style="color: black;">坏处</span>？</span></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPmdN31ciaHrftavIMQH5W0tl1Wy0qBGLXRxd8ibgZATB4YXHTunRvI6fTcJPYv86z2CMcvdWPDtgczQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">如上图所示：肠道广义分为大肠和小肠，小肠为消化管中最长的一段，<span style="color: black;">亦</span>是消化吸收的<span style="color: black;">重点</span>场所。成人全长约5～7m。分为十二指肠、空肠和回肠3部分。大肠<span style="color: black;">初始</span>段在右髂窝处与回肠相接，末端<span style="color: black;">最终</span>肛门，长约1.5m，分为盲肠、结肠（升结肠、横结肠、降结肠、乙状结肠）、直肠和肛管（4-5cm）4部分。直肠（rectum）<span style="color: black;">位置于</span>骨盆腔内，在第3骶椎水平接乙状结肠，向下沿第4～5骶椎和尾骨前面下降，穿过盆膈移<span style="color: black;">行径</span>肛管，全长约l0～14cm。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtYicUibhxzI69J0pumicZ90sV6TLzCjSwuO24W0ZU04XeonjGvT658jXtw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtP3EuxhpEZUddBL5OBx2aRW2WsGre0Z40TGLhAs2jPt3C4jmkiaB8YDw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">临床上将直肠癌分为低位直肠癌（距齿状线</span>5cm<span style="color: black;">以内）、中位直肠癌（距齿状线</span><span style="color: black;">5</span><span style="color: black;">～</span><span style="color: black;">10cm</span><span style="color: black;">）、高位直肠癌（距齿状线</span><span style="color: black;">10cm</span><span style="color: black;">以上）。这种<span style="color: black;">归类</span>对直肠癌根治手术方式的<span style="color: black;">选取</span>有<span style="color: black;">要紧</span>的参考价值。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtMiapgkqLV2wX2gt4ZN2TFXwDicZJIBl8zujs58GLMYpiaXIy3kSRQpiacw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtjNFVvs7UR1LMP6RCib3yEA9ibj5nAHeLUq10Q7IxJAnmdx7UmMy01yHg/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LticZYSDbnvTnmEQtE2so7ITQicxgB0crYq1obvPL5nUdNfVy9ScHzJKtQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">低位直肠，</span></span><span style="color: black;"><span style="color: black;">是直肠腹膜返折到齿状线一段直肠，长约</span>5~ 6<span style="color: black;">厘米，齿状线上</span><span style="color: black;">1.5</span><span style="color: black;">厘米<span style="color: black;">上下</span>的直肠因是埋在肛提肌之内，外科学上算是肛管的范围</span><span style="color: black;">,</span><span style="color: black;">但低位直肠癌<span style="color: black;">包含</span>了腹膜返折和</span></span><span style="color: black;"><span style="color: black;">齿状线</span></span><span style="color: black;"><span style="color: black;">之间肠段的癌肿。<span style="color: black;">亦</span>有作者将低位直肠癌定义为肿瘤下缘距肛缘</span>7<span style="color: black;">厘米以下或<span style="color: black;">位置于</span>直肠下</span><span style="color: black;">1/3</span><span style="color: black;">段的直肠癌。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> <span style="color: black;"><span style="color: black;">那样</span>何谓</span>“<span style="color: black;">超低位</span><span style="color: black;">”</span><span style="color: black;">？</span></span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">吻合位置在齿状线至其上方</span><span style="color: black;">2cm</span><span style="color: black;">内就定义为超低位</span></span></strong><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> <img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPmdN31ciaHrftavIMQH5W0tlT4OfALCCL1Xcp7Z0uURvWIvicicvIxIibmIT9nibmialXLh1ia1mcNhunrxw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPmdN31ciaHrftavIMQH5W0tlEDAZx714I1IFBEPMr4ibic98Iw8aWXY5gwjPuVC5j13Kjkc9OMGZRXKg/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"> 结</span></span><span style="color: black;">肠癌是<span style="color: black;">平常</span>的消化道恶性肿瘤，占胃肠道肿瘤的第二位。好发部位为直肠及直肠与乙状结肠交界处，占60%，发病多在40岁以后，男女之比为2：1。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">到<span style="color: black;">日前</span>为止，</span><span style="color: black;"><strong style="color: blue;">直肠癌治疗仍以外科手术，术前及术后放、化疗等为<span style="color: black;">重点</span>治疗手段</strong></span><span style="color: black;">。手术技术与辅助治疗的<span style="color: black;">持续</span>发展<span style="color: black;">极重</span>地延长了直肠癌病人的<span style="color: black;">存活</span>时间，<span style="color: black;">各样</span>保肛手术的广泛应用又<span style="color: black;">明显</span>减少了造口的比例，避免造口的心理影响，改善了生活质量。直肠癌<span style="color: black;">病人</span>经常有<span style="color: black;">心情</span>问题，严重者会诱发抑郁，对<span style="color: black;">病人</span>身心<span style="color: black;">导致</span>很大的创伤，加重病情。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">低位直肠癌的治疗原则</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一．早</span><span style="color: black;">期低位直肠癌</span><span style="color: black;">首选手术</span><span style="color: black;"><span style="color: black;">治疗。</span>1<span style="color: black;">、经腹直肠癌根治术。</span></span><span style="color: black;">低位直肠癌<span style="color: black;">因为</span>肿瘤位置较低，<span style="color: black;">通常</span>行经腹会阴联合直肠癌根治术，但有永久性造口，<span style="color: black;">病人</span>生活质量较差，随着外科手术技术的<span style="color: black;">持续</span>发展，</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">保肛手术越来越受到病人的<span style="color: black;">喜爱</span>，保肛手术需遵循个体化、</span>TME<span style="color: black;">、尽可能的<span style="color: black;">保存</span>盆腔自主神经</span></strong></span><span style="color: black;">。</span><span style="color: black;"><span style="color: black;">表率</span>术式：</span><span style="color: black;">1 <span style="color: black;">经括约肌间切除术</span><span style="color: black;">2 </span><span style="color: black;">经肛门拖出直肠切除吻合术</span><span style="color: black;">3 </span><span style="color: black;">腹腔镜下直肠癌根治术</span><span style="color: black;">4 </span><span style="color: black;"><span style="color: black;">设备</span>人直肠癌根治术</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> <span style="color: black;">日前</span>国际上<span style="color: black;">举荐</span><span style="color: black;">腹腔镜内括约肌切除术（</span></span><span style="color: black;">ISR</span><span style="color: black;">）<span style="color: black;">重点</span>适用于肛门功能较好的下列超低位</span>直肠癌<span style="color: black;">：（1）术前分期T1 ～ T2<span style="color: black;">病人</span>；（2）<span style="color: black;">发展</span>期</span>直肠癌<span style="color: black;">接受术前新辅助放化疗后降期至 T1 ～ T2 期;(（3）广基绒毛状腺瘤恶变。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9Lttlb1Aqltkop2bzuEybwFL1f8c4l5Fn1edIqwrfkpRy5Dicahf6cdUlQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"> <img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPmdN31ciaHrftavIMQH5W0tl7sy2KQVM5ziaTVxWGBnSrE93lk7iaPhCr6BTUWwZlPRgWlj70pqrBHibQ/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtmHicFfu2cUSGfUBR8nujtwTTcPDTKRZGg6mcYuib5qBEKQAxT1udp0mw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtKSuOYCsXHibDKwh8E3t02zwibjryOTOLayQT4DibpVibxficweic7sGbuibog/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 上图为直肠盆底神经，<span style="color: black;">重点</span><span style="color: black;">功效</span>：<span style="color: black;">肛门直肠神经<span style="color: black;">重点</span>来自下腹下丛(盆丛)，<span style="color: black;">位置于</span>腹膜反折部以下至肛提肌之间(骨盆直肠间隙)的腹膜外组织内，居髂内动脉与直</span></span><span style="color: black;">肠之间。盆腔自主神经<span style="color: black;">包含</span>上腹下丛、腹下神经、盆内脏神经（勃起神经）、盆腔神经丛、盆腔神经丛传出神经的分支<span style="color: black;">形成</span>。其中上腹下丛和腹下神经属于交感神经，后三者属于副交感神经或混合神经。</span><span style="color: black;"><strong style="color: blue;">男性的性功能及排尿功能受交感、副交感和躯体神经协调<span style="color: black;">掌控</span></strong></span><span style="color: black;">。其中，前两者合<span style="color: black;">叫作</span>为盆腔自主神经；躯体神经<span style="color: black;">重点</span>为阴部神经。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2. </span><span style="color: black;"><span style="color: black;">经腹会阴联合直肠癌根治术</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;"> 手术切除范围<span style="color: black;">包含</span>乙状结肠下部及其系膜和直肠<span style="color: black;">所有</span>、</span>肠系膜<span style="color: black;">下</span>动脉<span style="color: black;">和<span style="color: black;">周边</span>淋巴结、</span>肛提肌<span style="color: black;">、</span>坐骨<span style="color: black;">直肠窝内</span>脂肪<span style="color: black;">、肛管和肛门<span style="color: black;">周边</span></span>皮肤<span style="color: black;">约5cm直径以及<span style="color: black;">所有</span>肛管括约肌。乙状结肠近端在左下腹壁做永久性人造肛门。手术特点是病变切除较彻底，</span>治愈<span style="color: black;">率高，为下端直肠癌的标准手术。缺点是手术</span><span style="color: black;">损害</span><span style="color: black;"><span style="color: black;">很强</span>，需做永久性人造肛门。手术分腹部和</span>会阴<span style="color: black;">部两个手术组，先后或<span style="color: black;">同期</span>进行手术。</span></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">以往的腹壁造口术尤其是</span></span><span style="color: black;">Miles</span><span style="color: black;"><span style="color: black;">手术，挽救了许多</span></span><span style="color: black;"><span style="color: black;">直肠恶性肿瘤</span></span><span style="color: black;"><span style="color: black;"><span style="color: black;">病人</span>的生命，<span style="color: black;">然则</span>其<span style="color: black;">坏处</span>端使不少<span style="color: black;">病人</span>不乐意接受。尤其是在心理上<span style="color: black;">没</span>法接受<span style="color: black;">一生</span>都要带着个粪袋，给<span style="color: black;">病人</span>及家属带来<span style="color: black;">极重</span><span style="color: black;">不方便</span>，很容易形成社交<span style="color: black;">阻碍</span>，留下心理<span style="color: black;">暗影</span></span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtnuICxiaZDUCFE7kGpUPdwAI1F0RKQagMNN7T2CiaJWzporic8kAXJ1BYw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtbVCTIZ9KescnMnz2SM9n8AaCzXetanBd0ib3wKMZvQt9H5rxYzLAibKA/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/RsJTOV0EsPkiarBhHOf4nu77QCFicGe9LtPXys1S1Am6nicibibSG4rb2L2YdfZvXqLAzFdNxu4BNNhYx1n22qARH4g/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
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<h3 style="color: black; text-align: left; margin-bottom: 10px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">超低位直肠癌保肛手术<span style="color: black;">拥有</span>以下优点</span>:</span></strong></h3>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1<span style="color: black;">、与</span><span style="color: black;">Miles </span><span style="color: black;">切除肛门手术有<span style="color: black;">一样</span>良好的治疗效果</span><span style="color: black;">;</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2<span style="color: black;">、<span style="color: black;">保存</span>正常的排便功能使生活质量得以<span style="color: black;">加强</span>，<span style="color: black;">加强</span>病人手术后的自<span style="color: black;">自信心</span></span><span style="color: black;">;</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3<span style="color: black;">、经腹及肛门联合切除吻合暴露良好，并发症少</span><span style="color: black;">;</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 4<span style="color: black;">、超低位直肠癌保肛手术适应于以下病例</span><span style="color: black;">:(1)</span><span style="color: black;">高中分化腺癌</span><span style="color: black;">(2)</span><span style="color: black;"><span style="color: black;">没</span><span style="color: black;">周边</span>浸润。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">二．中晚期低位直肠癌先放疗再手术治疗原则。</p>
<span style="color: black;"><span style="color: black;">新辅助治疗在降低术后局部复发率方面优于术后的放化疗。<span style="color: black;">因此呢</span>，新辅助治疗已被</span>NCCN<span style="color: black;">指南<span style="color: black;">举荐</span>为<span style="color: black;">发展</span>期直肠癌的标准治疗模式，对距肛缘 </span><span style="color: black;">12 cm </span><span style="color: black;">以下的局部<span style="color: black;">发展</span>期直肠癌病人标准治疗为术前同步放化疗。</span></span><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;"><span style="color: black;">日前</span>认为直肠 </span><span style="color: black;">MRI</span><span style="color: black;">能够准确<span style="color: black;">供给</span>直肠与盆腔其他器官的解剖关系，被认为是低位直肠癌术前分期的<span style="color: black;">重点</span>手段</span></span><span style="color: black;"><span style="color: black;">，肿瘤侵犯肠壁深度为</span>T3<span style="color: black;">者<span style="color: black;">意见</span>行术前放疗</span></span></strong></span><span style="color: black;"><span style="color: black;">。<span style="color: black;">日前</span>有两种<span style="color: black;">方法</span>：一是短程放疗，</span>25Gy/5f/1w<span style="color: black;">，结束后</span><span style="color: black;">1 W</span><span style="color: black;">内手术；二是长程放化疗，</span><span style="color: black;">45-50.4Gy/25-28f/5~6 W</span><span style="color: black;">，联合</span><span style="color: black;">5-Fu</span><span style="color: black;">，治疗结束后</span><span style="color: black;">8~12W</span><span style="color: black;">内手术。</span></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">手术前放疗的优点<span style="color: black;">包含</span>：</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> <span style="color: black;"> ①杀灭亚临床病灶，减少手术中肿瘤种植机会;</span><span style="color: black;">②小肠活动好，受照射容积小，急性和晚期毒性反应较轻，病人容易接受全量放疗;</span><span style="color: black;"> ③手术前肿瘤区血供较丰富，细胞氧和较好，<span style="color: black;">增多</span>肿瘤放射<span style="color: black;">敏锐</span>性</span><span style="color: black;"> ④照射后肿瘤体积缩小，使原先<span style="color: black;">不可</span>切除的局部晚期病灶可行根治性切除，且<span style="color: black;">增多</span>了低位直肠癌的保肛机会。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 我国</span><span style="color: black;">大肠癌</span><span style="color: black;">中，直肠癌占60%～75%，而</span><strong style="color: blue;"><span style="color: black;">直肠癌中80%以上可用直肠指诊触及</span></strong><span style="color: black;">，<span style="color: black;">因此呢</span>要<span style="color: black;">注意</span>直肠指诊。<span style="color: black;">另外</span>，国内青年人直肠癌较国外多见，<span style="color: black;">因此呢</span>，对青年人直肠癌的</span><span style="color: black;">流行病学</span><span style="color: black;">特点应有充分<span style="color: black;">认识</span>，切不可因<span style="color: black;">青年</span>而<span style="color: black;">忽略</span>患大肠癌的可能。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">包头市肿瘤医院胃肠肿瘤外科二病区<span style="color: black;">日前</span><span style="color: black;">位置于</span>外科楼六楼，与胸外科合作，强强联手，是集腹部肿瘤的诊断、手术治疗、<span style="color: black;">研究</span>、<span style="color: black;">教育</span>于一体的新兴科室。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">科室<span style="color: black;">熟悉</span>开展如下业务：贲门癌全胃切除术、间置空肠全胃切除术、近端、远端胃癌根治术、左半、右半结肠癌根治性切除术、横结肠癌根治性切除术，乙状结肠癌根治性切除术、直肠癌低位前切除术、腹会阴联合直肠癌切除术、小肠肿瘤切除术、腹膜后肿瘤切除术、胰腺肿瘤切除术、脾肿瘤切除术、肝脏肿瘤切除术、阑尾切除术、疝气修补术、胆囊切除术等，并开展胃癌、结直肠癌的综合治疗。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">科室秉承“一切以病人为中心”的理念，团结协作，以精湛的医疗技术、良好的医德医风为广大<span style="color: black;">病人</span><span style="color: black;">供给</span><span style="color: black;">优秀</span>的医疗服务。</span></p>
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