胰腺囊性肿瘤病人最想认识的十大问题丨“医”面之缘
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">*仅供医学专业人士阅读参考</span></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">全国肿瘤防治宣传周，特邀复旦大学<span style="color: black;">附庸</span>肿瘤医院胰腺外科专家解答胰腺囊性肿瘤<span style="color: black;">病人</span>最关心的问题。</span></p><span style="color: black;">胰腺是一个神奇的器官，<span style="color: black;">同期</span><span style="color: black;">拥有</span>外分泌和内分泌两大功能。一旦胰腺功能受损，就可能<span style="color: black;">同期</span><span style="color: black;">显现</span>消化不良和血糖调节<span style="color: black;">反常</span>，影响<span style="color: black;">病人</span>的生活质量，严重者<span style="color: black;">乃至</span>危及生命。胰腺手术是<span style="color: black;">引起</span>胰腺功能受损的<span style="color: black;">原由</span>之一，而胰腺肿瘤是<span style="color: black;">引起</span>胰腺手术最<span style="color: black;">平常</span>的<span style="color: black;">原由</span>。随着人们生活水平的<span style="color: black;">加强</span>和健康<span style="color: black;">认识</span>的<span style="color: black;">加强</span>，越来越多的胰腺肿瘤如胰腺囊性肿瘤在体检中被<span style="color: black;">发掘</span>。</span><span style="color: black;">在全国肿瘤防治宣传周这个特殊的时间点，<strong style="color: blue;">“医学界”特邀复旦大学<span style="color: black;">附庸</span>肿瘤医院胰腺外科徐晓武教授与胰腺囊性肿瘤<span style="color: black;">病人</span>马桂秋女士就广大胰腺囊性肿瘤<span style="color: black;">病人</span>最关心的问题进行深度<span style="color: black;">交流</span>。</strong><span style="color: black;">期盼</span>这段对话能够<span style="color: black;">帮忙</span><span style="color: black;">更加多</span>胰腺囊性肿瘤<span style="color: black;">病人</span><span style="color: black;">认识</span>囊性肿瘤的诊治，并鼓励<span style="color: black;">更加多</span>病友。</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">4月18日19:00-20:00</span></strong></span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">扫描海报二维码观看直播</span></strong></span><span style="color: black;">↓↓↓</span>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">一</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">怎样</span><span style="color: black;">初期</span><span style="color: black;">发掘</span>胰腺囊性肿瘤？</strong></p><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">主持人：胰腺囊性肿瘤有<span style="color: black;">那些</span>临床表现？有<span style="color: black;">无</span><span style="color: black;">有些</span><span style="color: black;">能够</span>早<span style="color: black;">发掘</span>的手段？</span></strong></span></strong></span><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;">胰腺囊性肿瘤<span style="color: black;">常常</span><span style="color: black;">无</span><span style="color: black;">尤其</span><span style="color: black;">显著</span>的临床症状，<span style="color: black;">都数</span>就诊的<span style="color: black;">病人</span>都是<span style="color: black;">经过</span>体检<span style="color: black;">发掘</span>的。随着体检的普及，会有<span style="color: black;">海量</span>的胰腺囊性肿瘤<span style="color: black;">病人</span>被<span style="color: black;">发掘</span>并就诊，<span style="color: black;">通常</span><span style="color: black;">经过</span>腹部<span style="color: black;">加强</span>CT或MRI都<span style="color: black;">能够</span><span style="color: black;">初期</span><span style="color: black;">发掘</span>，部分人<span style="color: black;">亦</span><span style="color: black;">能够</span><span style="color: black;">经过</span>腹部<span style="color: black;">彩超</span><span style="color: black;">发掘</span>。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">二</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">那些</span><span style="color: black;">病人</span><span style="color: black;">必须</span>手术？</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">那些</span><span style="color: black;">病人</span><span style="color: black;">能够</span>保守治疗，<span style="color: black;">定时</span>随访？</strong></span></p><strong style="color: blue;"><span style="color: black;">主持人：所有胰腺囊性肿瘤都<span style="color: black;">必要</span>切除吗？<span style="color: black;">那些</span><span style="color: black;">病人</span><span style="color: black;">能够</span>随访？<span style="color: black;">那些</span><span style="color: black;">病人</span><span style="color: black;">必须</span>手术？有<span style="color: black;">无</span><span style="color: black;">有些</span><span style="color: black;">药品</span><span style="color: black;">能够</span>使肿瘤退缩？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;"><span style="color: black;">首要</span>，胰腺囊性肿瘤不可能<span style="color: black;">经过</span><span style="color: black;">药品</span>消除，但<span style="color: black;">亦</span>不是<span style="color: black;">每一个</span>胰腺囊性肿瘤<span style="color: black;">病人</span>都<span style="color: black;">必须</span>做手术。<span style="color: black;">咱们</span>应<span style="color: black;">按照</span>以下几点<span style="color: black;">思虑</span>对<span style="color: black;">病人</span>进行个体化的手术<span style="color: black;">评定</span>：</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">第1</span>点，看病灶<span style="color: black;">是不是</span>有恶变症状或恶变<span style="color: black;">危害</span>。</span></strong><span style="color: black;">恶变的高危<span style="color: black;">危害</span><span style="color: black;">包含</span>：肿瘤标志物如糖类抗原</span><span style="color: black;">（CA199）</span><span style="color: black;">的<span style="color: black;">上升</span>，囊肿的细微结构中有附壁结节的强化，肿瘤直径大于3cm，<span style="color: black;">短期</span>内肿瘤<span style="color: black;">忽然</span>增大，<span style="color: black;">同期</span>伴有胰管、尤其是主胰管的扩张等。</span><strong style="color: blue;"><span style="color: black;">第二点，<span style="color: black;">咱们</span>在<span style="color: black;">思虑</span>胰腺囊性肿瘤手术时，<span style="color: black;">亦</span>要兼顾<span style="color: black;">病人</span>的个人<span style="color: black;">原因</span>。</span></strong><strong style="color: blue;"><span style="color: black;"><span style="color: black;">首要</span>，要<span style="color: black;">思虑</span><span style="color: black;">病人</span>的年龄。</span></strong><span style="color: black;">胰腺囊性肿瘤是一类良性起病、发展缓慢、有潜在恶变可能的<span style="color: black;">疾患</span>，它的<span style="color: black;">危害</span>在于若干年后可能<span style="color: black;">显现</span>恶变。<span style="color: black;">因此</span><span style="color: black;">针对</span>高龄的<span style="color: black;">病人</span>，<span style="color: black;">咱们</span><span style="color: black;">通常</span>会<span style="color: black;">选取</span>比较保守的<span style="color: black;">方法</span>，<span style="color: black;">由于</span>手术<span style="color: black;">危害</span>对高龄<span style="color: black;">病人</span>来讲可能问题更大。<span style="color: black;">针对</span><span style="color: black;">青年</span><span style="color: black;">病人</span>，<span style="color: black;">咱们</span><span style="color: black;">举荐</span>采用积极的治疗手段，<span style="color: black;">由于</span>随着年龄的增长，潜在恶变<span style="color: black;">危害</span>会<span style="color: black;">升高</span>。<span style="color: black;">针对</span><span style="color: black;">青年</span><span style="color: black;">病人</span><span style="color: black;">来讲</span>手术是有<span style="color: black;">道理</span>的，<span style="color: black;">病人</span><span style="color: black;">亦</span>能从中获益。</span><strong style="color: blue;"><span style="color: black;">其次，要<span style="color: black;">思虑</span>囊肿部位。</span></strong><span style="color: black;">胰腺手术比较<span style="color: black;">繁杂</span>，不同囊肿部位的手术方式不同。<span style="color: black;">通常</span><span style="color: black;">来讲</span>，病变越靠近尾部，手术的创伤、代价都相对较小，安全性<span style="color: black;">亦</span>比较高。<span style="color: black;">针对</span>这类病变<span style="color: black;">咱们</span><span style="color: black;">能够</span><span style="color: black;">选取</span>比较积极的治疗手段。而病变靠近胰头，尤其是要做胰十二指肠大范围切除的<span style="color: black;">病人</span>，手术<span style="color: black;">危害</span>大，代价和创伤<span style="color: black;">亦</span>大。<span style="color: black;">针对</span>这类<span style="color: black;">病人</span>，<span style="color: black;">咱们</span><span style="color: black;">必须</span>兼顾恶变<span style="color: black;">危害</span>与手术代价，在两者之间取一个平衡。<span style="color: black;">因此</span>我<span style="color: black;">意见</span><span style="color: black;">病人</span>前往正规、有经验的胰腺中心去就诊，以接受合适的治疗策略。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">三</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">随访过程中<span style="color: black;">必须</span><span style="color: black;">重视</span>什么？</strong></p><strong style="color: blue;"><span style="color: black;">主持人：<span style="color: black;">那样</span><span style="color: black;">倘若</span>可以随访胰腺囊性肿瘤<span style="color: black;">病人</span>，在随访过程中<span style="color: black;">必须</span><span style="color: black;">重视</span><span style="color: black;">那些</span>方面？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;">胰腺囊性肿瘤本身<span style="color: black;">无</span>症状，<span style="color: black;">无</span>太多<span style="color: black;">必须</span>刻意<span style="color: black;">重视</span>的<span style="color: black;">地区</span>，<span style="color: black;">病人</span><span style="color: black;">能够</span>正常的工作、生活、社交，只是<span style="color: black;">必须</span><span style="color: black;">定时</span>随访。<span style="color: black;">无</span>高危<span style="color: black;">原因</span>或<span style="color: black;">无</span><span style="color: black;">知道</span>高危<span style="color: black;">原因</span>的<span style="color: black;">病人</span>每年一次随访<span style="color: black;">就可</span>。随访时，我<span style="color: black;">意见</span>采用CT、磁共振或超声内镜等能够比较客观反映胰腺囊性肿瘤特征的<span style="color: black;">检测</span><span style="color: black;">办法</span>，普通的腹部<span style="color: black;">彩超</span>可能达不到非常好的随访效果。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">四</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">手术方式有<span style="color: black;">那些</span>？</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">设备</span>人手术和腹腔镜手术哪个更好？</strong></span></p><strong style="color: blue;"><span style="color: black;">主持人：<span style="color: black;">倘若</span>是跟我<span style="color: black;">同样</span><span style="color: black;">选取</span>手术切除的<span style="color: black;">病人</span>，<span style="color: black;">日前</span><span style="color: black;">咱们</span>有<span style="color: black;">那些</span>手术方式呢？有<span style="color: black;">有些</span><span style="color: black;">大夫</span><span style="color: black;">举荐</span><span style="color: black;">设备</span>人手术，它与腹腔镜手术哪一个更好？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;">从手术操作的方式上来讲，传统胰腺外科以开腹手术为主，但近20年来腹腔镜手术与<span style="color: black;">设备</span>人手术等微创外科发展迅猛。胰腺囊性肿瘤手术<span style="color: black;">无</span>太多肿瘤学上的<span style="color: black;">需求</span></span><span style="color: black;">（如淋巴结清扫）</span><span style="color: black;">，非常适合于微创手术。</span><span style="color: black;">腹腔镜手术与<span style="color: black;">设备</span>人手术的差别在于腹腔镜手术是依靠外科<span style="color: black;">大夫</span>来直接操控手术器械，而<span style="color: black;">设备</span>人手术则借助了<span style="color: black;">设备</span>人的机械臂来完成手术。相较于腹腔镜手术，<span style="color: black;">设备</span>人手术最大的<span style="color: black;">优良</span>在于它有更加高倍的放大视野。腹腔镜手术<span style="color: black;">通常</span>能放大4~6倍，而<span style="color: black;">设备</span>人手术<span style="color: black;">能够</span>做到10倍、<span style="color: black;">乃至</span>30倍的放大，基本上等同于达到显微手术的效果。当然，<span style="color: black;">设备</span>人手术的手术<span style="color: black;">花费</span><span style="color: black;">亦</span>可能随之<span style="color: black;">增多</span>。<span style="color: black;">咱们</span><span style="color: black;">能够</span><span style="color: black;">按照</span>手术方式来<span style="color: black;">选取</span>腹腔镜手术或<span style="color: black;">设备</span>人手术，例如<span style="color: black;">保存</span>胰腺功能的手术<span style="color: black;">必须</span>分辨胰腺中非常细小的结构，<span style="color: black;">那样</span><span style="color: black;">选取</span><span style="color: black;">设备</span>人手术有非常大的<span style="color: black;">优良</span>。</span><span style="color: black;">传统的胰腺外科<span style="color: black;">仅有</span>两种手术方式，即胰头部病灶的胰十二指肠切除和胰尾部病灶的胰体尾切除。但胰腺囊性肿瘤<span style="color: black;">能够</span>不<span style="color: black;">必须</span>做这么大范围的切除。随着<span style="color: black;">咱们</span>对胰腺内部结构的认识愈发清晰，手术和解剖越做越精细，<span style="color: black;">有些</span><span style="color: black;">保存</span>胰腺功能的手术<span style="color: black;">作为</span>可能。正如这位主持人所经历的手术，她的囊性病灶在胰腺头部，<span style="color: black;">倘若</span><span style="color: black;">根据</span>传统方式，<span style="color: black;">必须</span>做一个很大的胰十二指肠切除，但<span style="color: black;">咱们</span>以微创手术的方式做了局部切除，很好地保持住了<span style="color: black;">病人</span>术后的胰腺功能。这类手术方式能以最小的创伤达到最好的治疗效果，这<span style="color: black;">亦</span>是能使<span style="color: black;">病人</span>真正获益的一个很<span style="color: black;">要紧</span>的方面。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">五</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">手术的并发症有<span style="color: black;">那些</span>？<span style="color: black;">怎样</span>处理？</strong></p><strong style="color: blue;"><span style="color: black;">主持人：<span style="color: black;">针对</span><span style="color: black;">咱们</span><span style="color: black;">病人</span>来讲，手术之后会不会有并发症、<span style="color: black;">副作用</span><span style="color: black;">亦</span>是<span style="color: black;">咱们</span>非常担心的，请问手术后有<span style="color: black;">那些</span>并发症？<span style="color: black;">怎样</span>处理？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;">任何一种外科手术都有手术<span style="color: black;">危害</span>及<span style="color: black;">出现</span>并发症的可能。胰腺手术的最大并发症是胰瘘，胰体尾切除后<span style="color: black;">出现</span>的胰瘘<span style="color: black;">重点</span>是单纯的胰瘘，其<span style="color: black;">危害</span>相对较小。胰十二指肠切除术后<span style="color: black;">出现</span>的胰瘘相对较严重。<span style="color: black;">那样</span><span style="color: black;">咱们</span>在做手术适应证<span style="color: black;">选取</span>时要<span style="color: black;">谨慎</span><span style="color: black;">有些</span>，<span style="color: black;">必须</span>综合<span style="color: black;">思虑</span>手术<span style="color: black;">危害</span>与恶变<span style="color: black;">危害</span>。</span><span style="color: black;">但胰腺手术的并发症<span style="color: black;">危害</span>与胰腺中心手术量<span style="color: black;">相关</span>。手术量越大的中心手术并发症的<span style="color: black;">掌控</span>越好，<span style="color: black;">出现</span>比例<span style="color: black;">亦</span>越小；<span style="color: black;">同期</span>，<span style="color: black;">她们</span>对并发症的处理<span style="color: black;">亦</span>更有经验。<span style="color: black;">病人</span>对待并发症要有一个正确的<span style="color: black;">心理</span>，手术并发症不可能百分百避免，但有经验的胰腺中心都有很好的处理并发症的经验，即使<span style="color: black;">出现</span>了并发症<span style="color: black;">亦</span>能够很好的处理。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">六</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">术后<span style="color: black;">膳食</span>有<span style="color: black;">那些</span><span style="color: black;">重视</span>事项？</strong></p><strong style="color: blue;"><span style="color: black;">主持人：术后<span style="color: black;">膳食</span>要<span style="color: black;">重视</span><span style="color: black;">那些</span>？<span style="color: black;">非常多</span>病友口中的发物到底能<span style="color: black;">不可</span>吃呢？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;"><span style="color: black;">针对</span>胰腺术后的生活<span style="color: black;">重视</span>事项，<span style="color: black;">不可</span>完全<span style="color: black;">忽略</span>，但<span style="color: black;">亦</span>不必过于紧张。胰腺术后<span style="color: black;">必须</span>重点关注<span style="color: black;">病人</span>的胰腺功能，<span style="color: black;">包含</span>外分泌功能与内分泌功能。</span><span style="color: black;"><strong style="color: blue;">外分泌功能</strong><span style="color: black;">重点</span>是<span style="color: black;">帮忙</span>消化，当胰腺外分泌功能不足时<span style="color: black;">摄食</span>油腻<span style="color: black;">食品</span>就会<span style="color: black;">引起</span>腹泻。<span style="color: black;">针对</span>这种<span style="color: black;">状况</span><span style="color: black;">能够</span><span style="color: black;">经过</span>添加胰酶的<span style="color: black;">办法</span>来改善症状，<span style="color: black;">同期</span>，<span style="color: black;">病人</span><span style="color: black;">亦</span>需减少或避免油腻<span style="color: black;">食品</span>的摄入。</span><span style="color: black;">胰腺<strong style="color: blue;">内分泌功能</strong><span style="color: black;">重点</span>是分泌胰岛素来<span style="color: black;">掌控</span>血糖水平，<span style="color: black;">因此</span><span style="color: black;">病人</span>接受胰腺手术后<span style="color: black;">必须</span>监测血糖水平。<span style="color: black;">倘若</span>血糖水平正常，则不必<span style="color: black;">尤其</span>处理；<span style="color: black;">倘若</span>血糖水平<span style="color: black;">上升</span>，<span style="color: black;">乃至</span>达到糖尿病的水平，则<span style="color: black;">必须</span>到内分泌科就诊，并<span style="color: black;">根据</span>糖尿病的<span style="color: black;">膳食</span>和生活习惯来处理。</span><span style="color: black;">若能够<span style="color: black;">掌控</span>好这两个方面，<span style="color: black;">病人</span>在术后<span style="color: black;">能够</span>进行正常的生活、工作、社交。</span><span style="color: black;">在西医概念里，任何<span style="color: black;">食品</span>被人体摄入并消化后，都会变成最基本的<span style="color: black;">食品</span>要素，如蛋白质、脂肪、维生素、碳水化合物等。<span style="color: black;">因此</span>不存在“发物”<span style="color: black;">这般</span>的概念，<span style="color: black;">亦</span><span style="color: black;">无</span>这方面的<span style="color: black;">尤其</span><span style="color: black;">需求</span>。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">七</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">术后<span style="color: black;">必须</span>服药吗？</strong></p><strong style="color: blue;"><span style="color: black;">主持人：胰腺术后要吃什么辅助的药吗？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;">这个取决于<span style="color: black;">病人</span>术后的胰腺功能。<span style="color: black;">倘若</span><span style="color: black;">病人</span>胰腺功能正常，就<span style="color: black;">无</span>必要在术后常规<span style="color: black;">吃下</span><span style="color: black;">药品</span>。<span style="color: black;">倘若</span><span style="color: black;">病人</span>的胰腺外分泌功能<span style="color: black;">显现</span>问题，<span style="color: black;">能够</span><span style="color: black;">经过</span>给予外源性胰酶来改善症状。</span><span style="color: black;">另一方面，<span style="color: black;">咱们</span>要关注<span style="color: black;">病人</span>的血糖问题。<span style="color: black;">倘若</span>血糖正常则不<span style="color: black;">必须</span><span style="color: black;">掌控</span>；<span style="color: black;">倘若</span><span style="color: black;">显现</span>临界的血糖<span style="color: black;">上升</span>，<span style="color: black;">咱们</span><span style="color: black;">举荐</span>进行生活方式的改善，即<span style="color: black;">掌控</span><span style="color: black;">膳食</span>、<span style="color: black;">增多</span>运动；<span style="color: black;">倘若</span><span style="color: black;">经过</span>正常的<span style="color: black;">膳食</span>都<span style="color: black;">不可</span><span style="color: black;">掌控</span>血糖，则<span style="color: black;">必须</span><span style="color: black;">根据</span>糖尿病的治疗<span style="color: black;">方法</span>来<span style="color: black;">掌控</span>，<span style="color: black;">首要</span>使用降糖药，<span style="color: black;">倘若</span>降糖药还达不到效果，就<span style="color: black;">必须</span><span style="color: black;">运用</span>胰岛素了。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">八</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">能够</span><span style="color: black;">运用</span>中药<span style="color: black;">护理</span>吗？</strong></p><strong style="color: blue;"><span style="color: black;">主持人：请问<span style="color: black;">吃下</span>中药<span style="color: black;">护理</span>有用吗？是不是<span style="color: black;">必须</span><span style="color: black;">吃下</span>中药<span style="color: black;">护理</span>呢？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;">我认为胰腺手术后<span style="color: black;">不消</span>常规进行中药<span style="color: black;">护理</span>。<span style="color: black;">针对</span><span style="color: black;">选取</span>中药<span style="color: black;">护理</span>的<span style="color: black;">病人</span>，我<span style="color: black;">意见</span><span style="color: black;">大众</span>去正规的、比<span style="color: black;">很强</span>的中医院就诊，并<span style="color: black;">吃下</span>正规的中医方剂，它相对而言比较有用，<span style="color: black;">亦</span>比较健康、安全。<span style="color: black;">有些</span>民间的土方、草方可能不仅<span style="color: black;">无</span><span style="color: black;">功效</span>，<span style="color: black;">乃至</span>会<span style="color: black;">引起</span>比较严重的肝功能损害。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">九</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">术后血糖<span style="color: black;">上升</span>怎么办？</strong></p><strong style="color: blue;"><span style="color: black;">主持人：<span style="color: black;">非常多</span>病友手术之后<span style="color: black;">显现</span>血糖<span style="color: black;">上升</span>，消化变差，请问这种<span style="color: black;">状况</span>多久会恢复？会不会发展成糖尿病？<span style="color: black;">或</span>成天拉肚子消化不良？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;">这个问题<span style="color: black;">触及</span>到胰腺的功能。胰腺手术后<span style="color: black;">病人</span>的胰腺功能存在一个慢慢恢复的过程，但<span style="color: black;">最后</span>其功能取决于<span style="color: black;">保存</span>了多少胰腺。<span style="color: black;">仅有</span>尽可能多地<span style="color: black;">保存</span><span style="color: black;">病人</span>的胰腺功能，<span style="color: black;">才可</span>真正避免这个问题。</span><span style="color: black;">胰腺手术<span style="color: black;">引起</span>的血糖<span style="color: black;">上升</span>并<span style="color: black;">不可</span><span style="color: black;">经过</span>时间延长得到改善，<span style="color: black;">必须</span><span style="color: black;">经过</span><span style="color: black;">药品</span>方式来<span style="color: black;">调节</span>。胰腺外分泌功能<span style="color: black;">欠好</span><span style="color: black;">引起</span>的<span style="color: black;">膳食</span>后腹泻<span style="color: black;">能够</span><span style="color: black;">经过</span><span style="color: black;">膳食</span>结构的<span style="color: black;">调节</span></span><span style="color: black;">（减少脂肪的摄入，改用高蛋白、多纤维素的<span style="color: black;">膳食</span>方式）</span><span style="color: black;">和<span style="color: black;">弥补</span>外源性胰酶来改善症状。</span><span style="color: black;">至于<span style="color: black;">病人</span>能否完全<span style="color: black;">经过</span>自我<span style="color: black;">调节</span>能力来实现症状的改善是因人而异的。有些<span style="color: black;">病人</span>胰腺切除的范围比较广，<span style="color: black;">那样</span>他的胰腺功能的丢失<span style="color: black;">没</span>法完全代偿，还是<span style="color: black;">必须</span>依赖<span style="color: black;">药品</span>来改善症状。</span><span style="color: black;">但<span style="color: black;">长时间</span>的<span style="color: black;">药品</span>维持对<span style="color: black;">病人</span>生活质量的影响很大，<span style="color: black;">因此</span><span style="color: black;">咱们</span>近年来<span style="color: black;">始终</span>推崇做<span style="color: black;">保存</span>功能的胰腺手术。<span style="color: black;">针对</span>这一类良性的病变，<span style="color: black;">咱们</span>应尽可能<span style="color: black;">选取</span>更<span style="color: black;">精细</span>的切除，避免做大范围的切除。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">十</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">术后应该怎么复查？</strong></p><strong style="color: blue;"><span style="color: black;">主持人：肿瘤<span style="color: black;">是不是</span>会复发<span style="color: black;">亦</span>是<span style="color: black;">咱们</span>病友非常关心的问题。请问<span style="color: black;">病人</span>术后应该怎么复查？</span></strong><strong style="color: blue;"><span style="color: black;">徐晓武教授：</span></strong><span style="color: black;"><span style="color: black;">仅有</span>恶性肿瘤存在复发的可能，<span style="color: black;">病人</span><span style="color: black;">必要</span>进行<span style="color: black;">定时</span>复查。良性肿瘤只要<span style="color: black;">经过</span>外科做了完整的切除就<span style="color: black;">无</span>复发的问题了，<span style="color: black;">病人</span>只需进行常规体检<span style="color: black;">就可</span>。<span style="color: black;">因此</span><span style="color: black;">咱们</span>积极<span style="color: black;">意见</span><span style="color: black;">青年</span><span style="color: black;">病人</span>去做手术，<span style="color: black;">由于</span><span style="color: black;">针对</span>这一类<span style="color: black;">病人</span>而言，肿瘤未切除前<span style="color: black;">必要</span>进行终身随访，直至<span style="color: black;">不可</span>耐受手术。这<span style="color: black;">针对</span><span style="color: black;">青年</span><span style="color: black;">病人</span>而言可能<span style="color: black;">寓意</span>着长达几十年的随访，而随访过程中，经济上、心理上的代价都是非常巨大的。<span style="color: black;">因此</span><span style="color: black;">经过</span>微创手术去除隐患后，<span style="color: black;">亦</span>避免了<span style="color: black;">病人</span>术后的<span style="color: black;">长时间</span>随<span style="color: black;">拜访</span>题。</span><strong style="color: blue;"><span style="color: black;">最后，徐晓武教授强调，</span></strong><span style="color: black;">随着体检的普及，越来越多的胰腺囊性肿瘤被<span style="color: black;">发掘</span>。事实上胰腺囊性肿瘤在初始<span style="color: black;">发掘</span>时都是良性病变，并非胰腺癌这类预后非常差的恶性肿瘤，<span style="color: black;">因此</span><span style="color: black;">大众</span><span style="color: black;">没</span>需焦虑。</span><span style="color: black;">其次，针对<span style="color: black;">每一个</span>胰腺囊性肿瘤<span style="color: black;">病人</span>，都应该有个体化的治疗策略，<span style="color: black;">意见</span><span style="color: black;">病人</span>去大的胰腺中心就诊，以更好地<span style="color: black;">认识</span><span style="color: black;">自己</span><span style="color: black;">疾患</span>，并<span style="color: black;">选取</span><span style="color: black;">恰当</span>的手术方式。</span><span style="color: black;">最后，应该<span style="color: black;">尽可能</span><span style="color: black;">选取</span>微创的<span style="color: black;">保存</span>胰腺功能的手术，以最大限度<span style="color: black;">保准</span><span style="color: black;">病人</span>术后的生活质量，避免<span style="color: black;">显现</span>严重的胰腺功能不足。</span><strong style="color: blue;">专家简介</strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/EjZcMyGNiatzZdgNUaOS6iawBudmoC4407vBaNPwKpb40QvQsjt3BPAibLsbud7OViaBzmbzibbayFfowwIYFxByexA/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><strong style="color: blue;"><span style="color: black;"><span style="color: black;">徐晓武</span>教授</span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">专家</span>医师/教授/博导</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">复旦大学<span style="color: black;">附庸</span>肿瘤医院胰腺外科副<span style="color: black;">专家</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">复旦大学<span style="color: black;">附庸</span>肿瘤医院胰腺微创手术中心<span style="color: black;">专家</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">中国医师协会微创外科委员会青年委员</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">中国抗癌协会胰腺癌专业委员会青年委员兼秘书</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">中国抗癌协会胰腺癌专业委员会微创诊治学组委员</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">上海市医学会普外科专科分会委员会青年委员</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">上海市医学会普外科专科分会微创学组委员</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">上海市抗癌协会胰腺癌专业委员会多区域诊疗协作青年学组副组长</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">上海市抗癌协会胰腺癌专业委员会委员</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/EjZcMyGNiatwBIrZo6Fho5XvVhiaER1BBkySQNId1mb7ErbVvRBVjicQqhK0DYolVtKyQ9Mj8WB2IN3kRIx6gDQbg/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">本文首发：医学界肿瘤频道</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本文作者：黄沫</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本文审核：徐晓武教授</p>
<span style="color: black;"><span style="color: black;">责任编辑：网友投稿</span>Sharon</span><span style="color: black;">版权申明</span><span style="color: black;"> 本文原创 如需转载请联系授权</span><span style="color: black;">- End -</span><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;"><img src="data:image/svg+xml,%3C%3Fxml version=1.0 encoding=UTF-8%3F%3E%3Csvg width=1px height=1px viewBox=0 0 1 1 version=1.1 xmlns=http://www.w3.org/2000/svg xmlns:xlink=http://www.w3.org/1999/xlink%3E%3Ctitle%3E%3C/title%3E%3Cg stroke=none stroke-width=1 fill=none fill-rule=evenodd fill-opacity=0%3E%3Cg transform=translate(-249.000000, -126.000000) fill=%23FFFFFF%3E%3Crect x=249 y=126 width=1 height=1%3E%3C/rect%3E%3C/g%3E%3C/g%3E%3C/svg%3E" style="width: 50%; margin-bottom: 20px;">
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