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[不可手术的老年患者的姑息性微创治疗]

[Palliative minimally invasive therapy in inoperable elderly patients].

作者信息

Ginsbach C, Riemann J F

机构信息

Medizinische Klinik C, Klinikums der Stadt Ludwigshafen/Rhein.

出版信息

Z Gerontol. 1992 Sep-Oct;25(5):319-24.

PMID:1279904
Abstract

The results of palliative endoscopic therapeutic maneuvers in patients over 80 years of age were retrospectively analyzed, covering a time period of 26 months. Aims of the therapeutic modalities were the recanalization of stenoses of the gastrointestinal tract, the long-term enteral nutrition or the abolition of a malignant obstructive jaundice. Appropriate procedures were combined bougienage and laser therapy, implantation of esophageal bridging tubes, percutaneous endoscopic gastroenterostomy (PEG), and the implantation of biliary endoprosthesis after endoscopic papillotomy. We evaluated (during the period January 1, 1990 until February 29, 1992) a total of 89 patients with various diseases, all of whom, at the time of examination, were candidates for surgery, either due to the extent of a tumor or due to a significant reduction of the physical status. The complication rate of the procedures of 2.9%, and the lethality risk of 0.9% showed no increase compared to patients of younger age. Therefore, minimal invasive endoscopic therapeutic procedures are strongly indicated in inoperable patients suffering from various diseases. Symptoms may be eliminated or significantly reduced with a few procedures which can be repeated many times.

摘要

对80岁以上患者进行姑息性内镜治疗操作的结果进行了回顾性分析,时间跨度为26个月。治疗方式的目的是使胃肠道狭窄再通、长期肠内营养或消除恶性梗阻性黄疸。适当的程序包括联合探条扩张术和激光治疗、食管桥接管植入、经皮内镜下胃造瘘术(PEG)以及内镜乳头切开术后胆道内支架植入。我们评估了(在1990年1月1日至1992年2月29日期间)总共89例患有各种疾病的患者,所有这些患者在检查时,由于肿瘤范围或身体状况显著下降,均为手术候选者。这些操作的并发症发生率为2.9%,致死风险为0.9%,与年轻患者相比没有增加。因此,对于患有各种疾病的无法手术的患者,强烈建议采用微创内镜治疗程序。通过少数可多次重复的程序,可以消除或显著减轻症状。

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