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无法手术的恶性肠阻塞的医疗处理。

Medical Management of Inoperable Malignant Bowel Obstruction.

机构信息

Sun Yat-sen University Sixth Affiliated Hospital, Guangzhou, Guangdong, China.

出版信息

Ann Pharmacother. 2021 Sep;55(9):1134-1145. doi: 10.1177/1060028020979773. Epub 2020 Dec 21.

Abstract

OBJECTIVE

To review medical management of inoperable malignant bowel obstruction.

DATA SOURCES

A literature review using PubMed and MEDLINE databases searching , , , , , , , , , , , , , , , , , , , and .

STUDY SELECTION AND DATA EXTRACTION

Randomized or observational studies, cohorts, case reports, or reviews written in English between 1983 and November 2020 were evaluated.

DATA SYNTHESIS

Malignant bowel obstruction (MBO) commonly occurs in patients with advanced or recurrent malignancies and severely affects the quality of life and survival of patients. Its management remains complex and variable. Medical management is the cornerstone of MBO treatment, with the goal of reducing distressing symptoms and optimizing quality of life. Until now, there has been neither a standard clinical approach nor registered medications to treat patients with inoperable MBO.

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE

This review provides information on the etiology, type and pathophysiology, and medical treatment of MBO and related adverse reactions of the drugs commonly used, which can greatly assist clinicians in making clinical decisions when treating MBO.

CONCLUSIONS

Published research shows that medical management of MBO mainly consists of antisecretory, anti-inflammatory strategies, controlling vomiting and pain, promoting emptying, preventing infection, and combination therapy. Being knowledgeable about the most current treatment options, the related adverse effects, and the evidence supporting different practices is critical for clinicians to provide individualized medical therapy for MBO patients.

摘要

目的

回顾无法手术的恶性肠梗阻的医学治疗方法。

资料来源

使用 PubMed 和 MEDLINE 数据库进行文献回顾搜索,包括,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,。

研究选择和数据提取

评估了 1983 年至 2020 年 11 月期间用英文发表的随机或观察性研究、队列研究、病例报告或综述。

数据综合

恶性肠梗阻(MBO)常见于晚期或复发性恶性肿瘤患者,严重影响患者的生活质量和生存。其治疗仍然复杂且多变。医学治疗是 MBO 治疗的基石,旨在减轻令人痛苦的症状并优化生活质量。到目前为止,还没有治疗不可手术性 MBO 的标准临床方法或注册药物。

与患者护理和临床实践的相关性

本综述提供了关于 MBO 的病因、类型和病理生理学以及常用药物的治疗和相关不良反应的信息,这极大地帮助了临床医生在治疗 MBO 时做出临床决策。

结论

已发表的研究表明,MBO 的医学治疗主要包括抗分泌、抗炎策略、控制呕吐和疼痛、促进排空、预防感染以及联合治疗。了解最新的治疗选择、相关不良反应以及不同实践的证据对于临床医生为 MBO 患者提供个体化的医学治疗至关重要。

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