基于循证医学的胃肠胰神经内分泌肿瘤患者全科综合照护策略的探讨

The comprehensive care strategy for patients with gastroenteropancreatic neuroendocrine tumor based on evidence-based medicine

目的以胃肠胰神经内分泌肿瘤(GEP-NET)为例,探讨基于循证医学的恶性肿瘤患者全科综合照护策略。方法以我院全科病房收治的GEP-NET患者为例,以"神经内分泌肿瘤"、"neuroendocrine tumor"为检索词检索UpToDate临床顾问决策系统,基于当前最佳研究证据及总结推荐意见探讨该类恶性肿瘤患者的全科综合照护策略。结果检索到包含"神经内分泌肿瘤"流行病学、病理学分类及分级、临床表现、诊断及分期、治疗及预后等相关主题的文献10篇,以GEP-NET分级系统为切入点,提出对预后不同的患者实施"分类管理"设想。结论实施循证医疗能够为全科医生规范化照护恶性肿瘤患者提供依据。

Objective To discuss the comprehensive care strategy for patients with GEP-NET in order to improve patient’s prognosis and quality of lives.Methods Taking the GEP-NET patients as an example,we searched the UpToDate clinical consultant decision system with the keywords"neuroendocrine tumor"to retrieve related literature.Based on the summary of the recommended opinions,the comprehensive care strategy for patients with this type of malignant tumor was discussed.Results Totally 10 references with guidelines include the neuroendocrine tumor epidemiology,pathology,classification and grading,clinical manifestations,diagnosis and staging,treatment and prognosis were retrieved.Taking the GEP-NET grading system as the starting point,this paper puts forward the idea of"classified management"for patients with different prognosis.Conclusion The implementation of evidence-based medicine might help the general practitioners to standardize the care of patients with malignant tumors.