肿瘤患者合并腹泻会严重影响患者的生活质量和治疗效果,甚至可危及生命。 腹泻可因肿瘤本身所致,也可由各 种治疗所引起,如放化疗、靶向药物、免疫治疗、肠道感染、药物、肿瘤术后、肠内营养不当等因素。 肿瘤相关性腹泻的临床表 现主要分为以下 3 种:胃肠道症状,全身中毒症状,水、电解质和酸碱平衡紊乱症状。 将这些症状归类为“不复杂” 或“复 杂”,有助于制订合适的治疗流程。 不复杂的肿瘤相关性腹泻为 1 级或 2 级腹泻且无其他并发症的患者,首选保守治疗,如健 康教育、口服补液和止泻治疗。 复杂的肿瘤相关性腹泻包括 1 级或 2 级腹泻伴随有危险因素(如中重度痉挛、≥2 级的恶心呕 吐、发热、败血症、消化道出血等)、3 或 4 级腹泻,则需要住院治疗并进一步评估病情和密切监测生命体征,可输注维持型基础 糖、电解质等进行积极治疗,应有包括胃肠病学专家在内的多学科团队进行评估。

Cancer patients with diarrhea seriously affect their quality of life and treatment effect and even life - threatening. Diarrhea can be caused by tumor itself but also by various treatments such as radiotherapy and chemotherapy targeted drugs immunotherapy intestinal infection drugs tumor surgery enteral nutrition and other factors. The clinical manifestations of tumor-associated diarrhea are mainly divided into the following three types gastrointestinal symptoms systemic intoxication symptoms and water electrolyte and acid-base balance disorders. Classifying these symptoms as " uncomplicated" or " complex" can help to determine the appropriate treatments. For patients with uncomplicated tumor - associated diarrhea of grade 1 or 2 and no other complications conservative treatments such as health education oral rehydration and antidiarrheal therapy is preferred. Complex tumor-associated diarrhea including grade 1 or 2 diarrhea with risk factors such as moderate to severe cramping ≥ grade 2 nausea and vomiting fever sepsis gastrointestinal bleeding etc. grade 3 or 4 diarrhea requires hospitalization and further evaluation of the condition and close monitoring of vital signs and can be actively treated with maintenance basic glucose and electrolyte infusion. A multidisciplinary team including gastroenterologists should conduct the assessment.