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[生活质量如何改变姑息性手术措施的适应症?]

[How does quality of life modify indications for palliative surgical measures?].

作者信息

Schlag P

机构信息

Sektion für Chirurgische Onkologie, Chirurgische Universitäts-Klinik Heidelberg.

出版信息

Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1989:129-35.

PMID:2485148
Abstract

Palliative operations have the aim of eliminating tumor symptoms and functional disorders and, if possible, improving the survival time, when incurability was diagnosed. The lacking possibility of cure requires careful risk-benefit evaluation of palliative operations. In this case, the general risk of such an intervention, its effectiveness and the patient's tolerance are relevant factors in the evaluation of life quality. It is important not only to prolong the life expectancy but also to alleviate various symptoms and avoid or eliminate physical deformations and functional disorders. Although it is still difficult to quantify "life quality", it is a decisive factor in palliative surgery beside the elimination of pain and maintenance of body functions. For example to avoid an artificial anus and relieve from pain is generally more important for patients than the statistical results of marginally prolonged survival time. Extensive palliative surgery is indicated when survival time and life quality can significantly be improved, compared to other treatment modalities.

摘要

姑息性手术的目的是消除肿瘤症状和功能障碍,若有可能,在诊断为无法治愈时延长生存时间。由于缺乏治愈的可能性,需要对姑息性手术进行仔细的风险效益评估。在这种情况下,此类干预的总体风险、其有效性以及患者的耐受性是评估生活质量的相关因素。不仅延长预期寿命很重要,减轻各种症状、避免或消除身体畸形和功能障碍也很重要。尽管仍然难以量化“生活质量”,但除了消除疼痛和维持身体功能外,它也是姑息性手术的一个决定性因素。例如,对患者来说,避免造瘘和缓解疼痛通常比生存期略有延长的统计结果更重要。与其他治疗方式相比,当生存时间和生活质量能够显著改善时,可考虑进行广泛的姑息性手术。

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