忘了说，美国用nasogastric suction 加G-J tube，予以胃肠内营养常见 （文献见内）。 我上面说的那个专家讲的和这篇文献差不多。
[PDF]Bowel Obstruction - National Cancer Institute
and sexual health, mucositis, nausea and vomiting, and skin problems. ... related to an intra-abdominal mass is present in about 90% of patients. .... Nasogastric suction decompresses the stomach and/or intestine; intravenous fluids.
The optimal treatment of bowel obstruction in patients with advanced cancer remains a
debated issue. Patients are usually considered suitable candidates for surgery when
survival is expected to be more than 2 months. Although surgery has been the primary
treatment for malignant obstruction, it is now recognized that some patients with
advanced disease or those in a poor general condition are unfit for surgery and require
alternative management to relieve distressing symptoms. A number of treatment options
are now available for patients with advanced and terminal cancer who develop intestinal
obstruction. Careful consideration of studies of prognostic indicators of survival in
patients with advanced cancer can help physicians, together with the patient and family
members, make appropriate therapeutic decisions. Medical treatment by continuous
subcutaneous or intravenous administration of opioids, corticosteroids, anticholinergic
medications, octreotide, and antiemetic medications can be an effective approach in
controlling pain, nausea, and vomiting in patients with inoperable gastrointestinal
obstruction. Consider nasogastric suction or percutaneous gastrostomy for patients with
refractory symptoms and/or upper bowel obstruction who do not respond satisfactorily
to pharmacologic measures alone. Direct efforts of the cancer care team toward
symptom control as well as the care of other aspects of the patient's suffering, including
psychological distress and spiritual concerns.
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