一、前言 加速康复外科（enhanced recovery after surgery,ERAS）指为使患者快速康复,在围手术期采用一系列经循证医学证据证实有效的优化处理措施,以减轻患者心理和生理的创伤应激反应,从而减少并发症,缩短住院时间,降低再人院风险及...一、前言 加速康复外科（enhanced recovery after surgery,ERAS）指为使患者快速康复,在围手术期采用一系列经循证医学证据证实有效的优化处理措施,以减轻患者心理和生理的创伤应激反应,从而减少并发症,缩短住院时间,降低再人院风险及死亡风险,同时降低医疗费用.展开更多
目的探讨甲状腺手术后甲状腺功能减退症(术后甲减)患者左旋甲状腺素钠(L-T4)的合适替代治疗剂量。方法术后甲减患者93例,根据甲状腺残留量分为全切组21例、非全切组72例,替代治疗后计算并比较两组单位体重剂量(Per/kg body mass dosing,...目的探讨甲状腺手术后甲状腺功能减退症(术后甲减)患者左旋甲状腺素钠(L-T4)的合适替代治疗剂量。方法术后甲减患者93例,根据甲状腺残留量分为全切组21例、非全切组72例,替代治疗后计算并比较两组单位体重剂量(Per/kg body mass dosing,PBMD)的差异,并分别比较两组PBMD与1.6μg/kg剂量的差异;对非全切组男女患者L-T4替代治疗剂量与体重的关系分别进行线性回归分析。结果全切组与非全切组患者PBMD分别为(1.8±0.1)μg/kg、(1.4±0.2)μg/kg,与1.6μg/kg剂量对比,差异均有统计学意义(P<0.05,P<0.01);两组均数比较差异亦有统计学意义(P<0.01)。非全切组男女患者替代治疗剂量分别为(99.0±16.8)μg、(93.0±18.1)μg,两者差异无统计学意义(P=0.153);非全切组男女患者L-T4替代治疗剂量与体重均高度相关。结论术后甲减患者的L-T4替代治疗剂量需根据患者甲状腺的残留量和性别来制定。展开更多
There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and ...There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.展开更多
China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and ...China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.展开更多
文摘目的探讨甲状腺手术后甲状腺功能减退症(术后甲减)患者左旋甲状腺素钠(L-T4)的合适替代治疗剂量。方法术后甲减患者93例,根据甲状腺残留量分为全切组21例、非全切组72例,替代治疗后计算并比较两组单位体重剂量(Per/kg body mass dosing,PBMD)的差异,并分别比较两组PBMD与1.6μg/kg剂量的差异;对非全切组男女患者L-T4替代治疗剂量与体重的关系分别进行线性回归分析。结果全切组与非全切组患者PBMD分别为(1.8±0.1)μg/kg、(1.4±0.2)μg/kg,与1.6μg/kg剂量对比,差异均有统计学意义(P<0.05,P<0.01);两组均数比较差异亦有统计学意义(P<0.01)。非全切组男女患者替代治疗剂量分别为(99.0±16.8)μg、(93.0±18.1)μg,两者差异无统计学意义(P=0.153);非全切组男女患者L-T4替代治疗剂量与体重均高度相关。结论术后甲减患者的L-T4替代治疗剂量需根据患者甲状腺的残留量和性别来制定。
文摘There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.
文摘日间手术（Ambulatory Surgery/Day Surgery）的概念最早由英格兰的Nicoll医师提出,随着国际日间手术协会（The International Association of Ambulatory Surgery,IAAS）成立,日间手术已发展成为一种较成熟的手术管理模式。
文摘China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.
