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진행된 위암 환자에게 발생한 범복막염 치료의 완화의학적 접근 : 대한가정의학회 완화의학연구회 세미나를 기초로 하여

Other Titles
 Panperitonitis with Advanced Gastric Cancer - Based on Seminar of Korean Family Medicine Palliative Medicine Research Group - 
Authors
 정윤주  ;  심재용  ;  김대균  ;  최윤선 
Citation
 Korean Journal of Hospice and Palliative Care (한국호스피스완화의료학회지), Vol.9(1) : 35-39, 2006 
Journal Title
Korean Journal of Hospice and Palliative Care(한국호스피스완화의료학회지)
ISSN
 1229-1285 
Issue Date
2006
Keywords
Advanced gastric cancer ; Panperitonitis ; Parenteral hydration nasogastric tube ; Palliative medicine
Abstract
A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
Yonsei Authors
Shim, Jae Yong(심재용) ORCID logo https://orcid.org/0000-0002-9561-9230
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/110004
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