| 陶亚利,阮荣蔚,王 实.内镜在胃恶性梗阻中的临床应用进展[J].中国肿瘤,2018,27(12):926-932. |
| 内镜在胃恶性梗阻中的临床应用进展 |
| Progress in Application of Endoscopy in Malignant Gastric Obstruction |
| 投稿时间：2018-09-01 |
| DOI：10.11735/j.issn.1004-0242.2018.12.A007 |
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| 中文关键词: 胃恶性梗阻 鼻胃肠管 经皮内镜胃造瘘 经皮内镜空肠造瘘 金属支架 超声内镜引导下胃肠吻合 |
| 英文关键词:malignant gastric obstruction nasoenteric feeding tubes percutaneous endoscopic gastrostomy percutaneous endoscopic jejunostomy metal stents endoscopic ultrasound-guided gastroenterostomy |
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| 中文摘要: |
| 摘 要：恶性梗阻是进展期胃癌的常见并发症，因梗阻引起的恶心呕吐、进食困难常导致严重营养不良、电解质紊乱，使患者无法进一步耐受抗肿瘤治疗，甚至加速患者的死亡。对于此类患者，如何解除梗阻或建立合适的营养通路是改善预后的关键。目前主要的内镜治疗手段有肠内营养管饲治疗（包括短期的内镜下鼻胃肠管置入和长期的经皮内镜胃或空肠造瘘术）和自膨式金属支架内镜置入治疗，金属支架是外科胃肠吻合术外解除恶性梗阻的首选治疗。超声内镜引导下胃肠吻合术是一项新兴技术，兼具创伤小和长期缓解症状的优点，但临床疗效和安全性尚需大样本的多中心前瞻性研究进一步论证。 |
| 英文摘要: |
| Abstract：Malignant obstruction is common in patients with advanced gastric cancer. It is gene-rally associated with nausea，vomiting，dysphagia and may cause serious malnutrition and electrolyte disorder, which lead to inability to receive the following treatment and even worsen their survive. The key point to improve those patients prognosis is to relieve the obstruction and establish appropriate nutrition access. The current endoscopic management for enteral access establishment includes short-term options, such as endoscope-assisted placement of nasoenteric feeding tube and long-term solutions, such as percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy. The endoscopic deployment of self-expandable metal stents has already become an effective alternative to surgical bypass for malignant gastric obstruction. Endoscopic ultrasound-guided gastroenterostomy is another new and promising technique that can provide sustained palliation while with only minimal invasion. But its clinical efficacy and safety need to be further verified in multi-center prospective studies with larger sample. |
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