Rezk Youssef, Timmins Patrick F, Smith Howard S
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Albany Medical College, Albany, NY 12208, USA.
Am J Hosp Palliat Care. 2011 Aug;28(5):356-74. doi: 10.1177/1049909110392204. Epub 2010 Dec 26.
Patients with advanced gynecologic malignancies have a multitude of symptoms; pain, nausea, and vomiting, constipation, anorexia, diarrhea, dyspnea, as well as symptoms resulting from intestinal obstruction, hypercalcemia, ascites, and/or ureteral obstruction. Pain is best addressed through a multimodal approach. The optimum palliative management of end-stage malignant intestinal obstruction remains controversial, with no clear guidelines governing the choice of surgical versus medical management. Patient selection for palliative surgery, therefore, should be highly individualized because only carefully selected candidates may derive real benefit from such surgeries. There remains a real need for more emphasis on palliative care education in training programs.
晚期妇科恶性肿瘤患者有多种症状；疼痛、恶心、呕吐、便秘、厌食、腹泻、呼吸困难，以及肠梗阻、高钙血症、腹水和/或输尿管梗阻引起的症状。疼痛最好通过多模式方法来处理。终末期恶性肠梗阻的最佳姑息治疗仍存在争议，对于手术治疗与药物治疗的选择没有明确的指导方针。因此，姑息性手术的患者选择应高度个体化，因为只有经过精心挑选的患者才可能真正从这类手术中获益。培训项目中确实仍需要更加强调姑息治疗教育。
