腸胃道基質腫瘤病患之呼吸照護經驗

Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract, which is mediated by kit oncogenic signaling mechanisms. Such tumors usually related to activate mutations in kit tyrosine kinases that are continually active in the absence of a normal stimulus, leading to increased cell proliferation. There was no effective treatment and always underdiagnosed in the past. Recently, the use of drug Glivec has been proven effective and increasing survival rate in the treatment of metastatic GISTs. It is the only effective medication in GISTs now.
The patient was diagnosed as GISTs when the tumor was huge with many complications. It was highly resistant to medical therapy. After the patient received surgical resection, he developed acute lung injury which might be related to blood transfusion and resulted in acute respiratory failure. Endotracheal intubation and mechanical ventilation were used to support his respiratory function and continuous venous to venous hemodialysis was applied to excrete excess fluid from the body. Because of the poor control of infection, the patient was expired one month later. In this report, we will discuss the critical role of respiratory therapist in mechanical ventilation strategy to improve the patient's respiratory function. The importance of treating his underlying disease and effective infection control for improving prognosis of GISTs patients were also emphasized.