转院依据 (3)

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活检报告、肿标报告、医嘱有下列描述者必须转院到省肿瘤医院治疗

肠镜取样活检化验报告结果是粘液腺癌或印戒淋巴癌的；癌胚抗原指标数值达到15以上的；其它肿标数值有2个以上肿标超标一倍以上的；医生说患者需要做术前新辅助放化疗再手术的，上述两种报告或医嘱有其中一种的，必须转院到省肿瘤医院诊疗。

  1. 肠镜取样活检化验报告结果是粘液腺癌或印戒淋巴癌的患者要尽快转院到省肿瘤医院以上专业医院治疗。

活检报告结果是粘液腺癌或者印戒淋巴癌者，或者粘液腺癌混合印戒淋巴癌者，证明患者得的肠癌是周边侵犯能力特别强的恶性肿瘤；肠癌肿瘤知识扎实，治疗经验丰富的省肿瘤医院专家，治疗这种周边侵犯和远端转移能力特别强的患者，他们会有特别的治疗措施。比如：检查范围和切除范围会有预见性的考虑印戒淋巴癌的快速侵犯能力因素，放疗时的剂量和次数，化疗方案的强度会相应的加强，甚至术后放化疗时间都会相应的提前，有些专业肿瘤医院会提前到术后15天就进入放化疗疗程，而普通腺癌一般的放化疗疗程都是术后一个月；而省肿瘤医院以下医院由于接诊这种病情的患者比较少，积累治疗印戒淋巴癌的经验和理解不足，多数都按照一般的腺癌流程治疗，从而耽误了印戒淋巴癌治疗的宝贵时间和没有相应有效的治疗措施，导致后期的复发转移概率大大的提高。

2. 癌胚抗原指标数值达到15以上的；其它肿标数值有2个以上肿标超标一倍以上的；要转院到省肿瘤医院以上专业医院治疗。

肿瘤标志物报告里，癌胚抗原cea超过15左右时，经验上肿瘤就具备通过血行系统转移到全身的能力了；这种患者除了常规的肠癌肿瘤肠段周边的仔细检查，肝肺的详细检查之外，还要检查全身其它经验上有可能转移的器官，而这种详细的检查，快速、精准高效率的检查只有专业的省肿瘤医院以上医院有意识去做检查，从而发现其它器官和身体部位的侵犯转移病灶，从而采取相应的多学科联合会诊后，再制定治疗方案和相应的手术方案。

3. 医生说患者需要做术前新辅助放化疗再手术的低位直肠癌患者，要转院到省肿瘤医院以上专业医院治疗。

医生说要先做术前新辅助放化疗的患者，证明患者肠肿瘤比较大或者周边侵犯比较复杂了，才需要做术前新辅助放化疗，这种手术一般地级市的医生做不好这种手术，术前放疗剂量和次数甚至放疗定位定得不准，都会导致吻合口过度放疗，导致手术时吻合口吻合不好而造成吻合口漏，或者因为害怕过度放疗而少做放疗或者不做放疗，而导致放疗不足、不准，导致术后吻合口周边还有残留的癌细胞、癌结节，被侵犯的淋巴结，导致术后做完后续的化疗疗程之后，术区的癌细胞无法杀干净，而导致复发转移。

所以，医嘱需要做术前放化疗的患者，要果断转院到省肿瘤医院做新辅助治疗之后找专家做手术才切得干净，省肿瘤医院制定的放疗方案比较专业，放疗设备定位的精准度比较高，操作放疗设备的医生水平比较高，对放疗剂量和放疗强度的把握比较精准，对放疗区域的器官组织比较了解，放疗误伤周边功能器官的概率低，放疗辅助药物齐全，做完术前新辅助放化疗之后患者休息时间把握精准，不会出现术后吻合口吻合不好导致吻合口漏的问题或大大的减少出现这种问题的概率，而出现这种问题的时候，补救措施比较专业及时，在整个治疗疗程的控制上比较专业，多专业联合会诊、联合手术的整体条件比较好，能够精准、及时的处理这些患者复杂治疗的一系列问题，大大的提高患者的安全保肛率、治愈率或者五年生存率。

相关文章 Related posts:

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化疗前内科检查血指标和生化指标的原因与重要性
腸癌復發 複查後應變診療篇 | 復發轉移跡像明顯的內地患者 要轉院到省腫瘤醫院以上專業醫院診療的原因
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