新型冠状病毒肺炎背景下胃肠间质瘤的诊疗策略  

Treatment strategy of gastrointestinal stromal tumors in the background of COVID⁃19

作　　者：王晓然[1] 胡旭华[1] 李政 李保坤 牛文博 周超熙[1] 于滨[1] 张振亚[1] 张雪娜[1] 高阳[1] 王贵英[1,2] Wang Xiaoran;Hu Xuhua;Li Zheng;Li Baokun;Niu Wenbo;Zhou Chaoxi;Yu Bin;Zhang Zhenya;Zhang Xuena;Gao Yang;Wang Guiying(The Second General Surgery,the Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050000,China;Department of Gastrointestinal Surgery,the Third Hospital of Hebei Medical University,Hebei Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第四医院外二科,石家庄050000 [2]河北医科大学第三医院胃肠外科,石家庄050000

出　　处：《中华胃肠外科杂志》2021年第9期825-829,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：河北省自然科学基金重点项目(H2020206485);中央引导地方科技发展资金项目(206Z7705G);2019年河北省政府资助临床医学优秀人才培养项目。

摘　　要：新型冠状病毒(SARS⁃CoV⁃2)引起的新型冠状病毒肺炎(COVID⁃19,以下简称新冠肺炎)具有全球性流行、传染性极强、死亡基数极大的特点。在我国,由于采取了积极主动的全民防控策略,有效遏制了病毒传播的途径,使新冠肺炎得到了很好的控制;但同时,这也对现有条件下的医疗结构模式带来了巨大的冲击,对于恶性肿瘤等慢性疾病患者的治疗产生了客观影响。本文基于国内外文献进展及笔者团队实际处理经验,就胃肠间质瘤(GIST)患者在疫情期间的治疗策略进行思考,重点对原发性GIST进行风险分层,并根据不同分层制定相应的治疗策略,包括延迟手术的影响、医疗资源的利用负担、手术时间等待的紧迫感和急诊手术处理原则等几方面。此外,我们着重探讨了非手术方法的证据级别,以期在资源有限的情况下,针对不同GIST的优先级,建立“优先级处理原则”的整体治疗策略来指导临床治疗。COVID⁃19,caused by SARS⁃COV⁃2,has the characteristics of world epidemic,highly infectious and large base of death.In China,transmission route of SARS⁃COV⁃2 has been contained so effectively that COVID⁃19 has been well controlled due to the proactive national prevention and control strategy.However,not only does it bring a huge impact on the existing medical structure model,but also an objective impact on the treatment of patients with chronic diseases such as malignant tumors.Based on the progress reported in the domestic and international literatures and the actual management experience of our team,this paper reflects on the treatment strategies for patients with gastrointestinal stromal tumor(GIST)during the epidemic period of COVID⁃19.We focus on risk stratification for primary GIST and forming treatment strategies accordingly.Major considerations include the impact of delayed operation,the burden of medical resources,the waiting time for elective operation,and the principle of emergency operation.In addition,we focus on the level of evidence for non⁃surgical approaches with a view to developing a holistic strategy of"priority management principles"to guide clinical treatment in the context of limited resources and different GIST priorities.

关 键 词：新型冠状病毒肺炎 胃肠间质瘤 治疗策略 分层治疗 

分 类 号：R735[医药卫生—肿瘤]