[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$f_ynU7_KvcEiQfnG6Xyo5bIoGqZmyvu7OlHTKSS3hrF0":8,"$fXkGiQpItbGWajOsk_5FXceuD9jXUZ-FuyMoSguxulzA":55,"$fwrnYuxv_hhx6DJVPNNUm9OfpHOPrDVHT3rJHhtLYJv8":59},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":54},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"hospital":17,"department":18,"postsTitle":19,"materialTotal":20,"videoTotal":21,"isConcern":7,"title":22,"coverVertical":23,"coverAcross":24,"content":25,"description":26,"views":27,"likes":21,"isThumbsUp":7,"isCollection":7,"collections":21,"createTime":28,"seoTitle":22,"seoKeywords":29,"seoDescription":30,"shelvesTime":31,"version":32,"menus":33,"menuId":35,"type":42,"quality":53,"commentCount":21,"isComment":42},48525,868808,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//iTCP1DSvplAFJhNCT6SR8jINhAgp8TZa.png","王凯来","浙江大学医学院附属第二医院","肿瘤科","住院医师",20,0,"全面认识结肠癌——从症状到治疗的全面指导","","https://ystcdn.venuertc.com/venue/AI/8d6e86f4-b123-4ec9-b91d-1a148e11107e.jpg","\u003Cdiv class=\"material-colon-cancer-guide-root\">\n  \u003Ch1 id=\"material_title\" class=\"material-colon-cancer-guide-title\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">\n    \u003Cspan>全面认识结肠癌——从症状到治疗的全面指导\u003C/span>\n    \u003Cspan class=\"material-colon-cancer-guide-emoji\">🩺\u003C/span>\n  \u003C/h1>\n\n  \u003Cdiv class=\"material-colon-cancer-guide-intro\">\n    晚饭桌上，家人在讨论健康体检时，话题不知不觉转到了大肠肿瘤。有的人觉得这离自己很远，有人却好奇什么是结肠癌，担心自己会不会有风险。其实，了解这类疾病没大家想得那么难，也不需要全靠高深的医学词汇。今天就用通俗的话，一步一步把结肠癌这件事说清楚，让你读完心里明明白白。\n  \u003C/div>\n\n  \u003C!-- 01 结肠癌是什么？ -->\n  \u003Csection class=\"material-colon-cancer-guide-section\" style=\"background: linear-gradient(100deg, #f4f8fb 60%, #e3e8ef 100%);\">\n    \u003Ch2 class=\"material-colon-cancer-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">01 结肠癌到底是什么？\u003C/h2>\n    \u003Cdiv class=\"material-colon-cancer-guide-content\">\n      \u003Cp>\n        说起来，结肠癌其实就是大肠（也叫结肠）里出现了异常增生的细胞，这些细胞慢慢形成肿块。正常状态下，大肠就像一段“输送管道”，负责把身体不需要的东西运走。但有时候，管道内壁可能冒出“新来的细胞”，如果它们变得不受控制，就会发展为肿瘤，进一步发展成结肠癌。\n      \u003C/p>\n      \u003Cp>\n        全球范围来看，结肠癌排在恶性肿瘤发病和死亡的前列。数据显示，结直肠癌占全部癌症病例的近10%，不少人发现时已经较晚（World Health Organization, 2023）。年龄通常是一个明显风险，尤其是50岁以上的人群更要关注。出现晚期转移后，治疗难度也会大大增加，所以越早关注越好。\n      \u003C/p>\n      \u003Cdiv class=\"material-colon-cancer-guide-reminder\">\u003Cspan>🔎\u003C/span> 这意味着，即使平时没有不舒服，40岁以上的人群也别掉以轻心。\u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 02 结肠癌的主要症状有哪些？ -->\n  \u003Csection class=\"material-colon-cancer-guide-section\" style=\"background: linear-gradient(100deg, #f7faf4 60%, #eaf4e3 100%);\">\n    \u003Ch2 class=\"material-colon-cancer-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">02 我可能怎么发现结肠癌的“信号”？\u003C/h2>\n    \u003Cdiv class=\"material-colon-cancer-guide-content\">\n      \u003Cp>\n        其实，不少人早期几乎没有症状，日常生活完全未受影响。但如果留心，“肠道”有时候会悄悄发出一些小信号，你别把它们当作普通的消化问题。\n      \u003C/p>\n      \u003Cul class=\"material-colon-cancer-guide-list\">\n        \u003Cli>\n          \u003Cstrong>排便习惯改变：\u003C/strong>\n          比如近期总是便秘或者腹泻，原本规律的大便突然乱套，偶尔换成细长条的形状。如果原以为是饮食问题，但持续两三周还没恢复，就要当回事了。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>出血：\u003C/strong>\n          一些人会在马桶看到粪便中混有鲜红或暗色的血，但量少容易被忽略。有的人干脆以为是痔疮，这种想法有时会耽误真正的疾病。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>身体不明原因消瘦：\u003C/strong>\n          没有特别控制饮食，却发现自己慢慢变瘦了，有时候更容易疲乏。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>腹部不适：\u003C/strong>\n          肚子隐隐作痛、胀气，一天到晚感觉腹部闷胀，特别是在饭后更明显。有些人还会突然出现肠梗阻症状（肚子疼、腹胀严重、不能正常排便）。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cdiv class=\"material-colon-cancer-guide-reminder\">\n        \u003Cspan>👀\u003C/span> 这些警示信号如果持续出现，最好别只靠自我观察，及早去医院做个检查比较妥当。\n      \u003C/div>\n      \u003Cdiv class=\"material-colon-cancer-guide-case\">\n        比如有位55岁的男士，平时身体健康，两个月前做鼻咽癌复查时，医生建议他查一下肿瘤标志物，结果发现异常。后来肠镜发现结肠上有个小肿块，手术后证明是结肠癌。这说明很多患者不是因为难以忍受的疼痛才被发现，而是偶然体检才“捉住”。\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 03 结肠癌的成因是什么？ -->\n  \u003Csection class=\"material-colon-cancer-guide-section\" style=\"background: linear-gradient(100deg, #faf7f4 60%, #f4ece3 100%);\">\n    \u003Ch2 class=\"material-colon-cancer-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">03 为什么会得结肠癌？\u003C/h2>\n    \u003Cdiv class=\"material-colon-cancer-guide-content\">\n      \u003Cp>\n        结肠癌的发生大多不是“说中就中”，更多是各种因素长期叠加的结果。简单来说，可以从以下几个方面来理解：\n      \u003C/p>\n      \u003Col class=\"material-colon-cancer-guide-list\">\n        \u003Cli>\n          \u003Cstrong>遗传因素：\u003C/strong>\n          如果家族里有直系亲属得过结肠癌，或者有遗传性肠息肉病、林奇综合征等，这类人群风险会明显增高（Lynch et al., 2015）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>年龄增长：\u003C/strong>\n          随着年龄增长，细胞修复能力下降，基因突变积累，结肠癌风险随之增加。多数患者在50岁以后发病。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>慢性肠道疾病：\u003C/strong>\n          患有慢性炎症性肠病（如溃疡性结肠炎、克罗恩病）者，如果发病超过十年，肠道黏膜反复修复更容易发生异常增生（Jess et al., 2012）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>生活方式影响：\u003C/strong>\n          饮食长期以高脂、低纤维、少蔬果为主，喜欢吃加工肉制品，加之缺乏运动，这些习惯都会增加风险。吸烟和经常大量饮酒也会“推波助澜”。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>其他慢病共存：\u003C/strong>\n          糖尿病、高血压、肥胖等慢性疾病，会通过多种机制降低身体自我防护能力。\n        \u003C/li>\n      \u003C/ol>\n      \u003Cp>\n        需要说明，各种风险因素只是提高概率，没有任何一种因素能单独决定是否得病，就像阳伞只能尽量挡住雨，不能保证“绝对不会淋湿”。\n      \u003C/p>\n      \u003Cdiv class=\"material-colon-cancer-guide-reminder\">\n        \u003Cspan>🧬\u003C/span> 有相关家族病史或自身有基础慢病的人，应该增加对肠道健康的关注频次。\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 04 如何进行结肠癌的诊断？ -->\n  \u003Csection class=\"material-colon-cancer-guide-section\" style=\"background: linear-gradient(100deg, #f4fafb 60%, #e3eef4 100%);\">\n    \u003Ch2 class=\"material-colon-cancer-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">04 医生是怎么确诊结肠癌的？\u003C/h2>\n    \u003Cdiv class=\"material-colon-cancer-guide-content\">\n      \u003Cp>\n        如果怀疑肠道有问题，最直接的办法是做肠镜检查。肠镜就像是给肠道“做体检”，可以把肠壁看得一清二楚。遇到“可疑点”，医生会顺手取点组织做病理检查，从而判定是不是癌变。\n      \u003C/p>\n      \u003Cp>\n        一般流程会包括：\n      \u003C/p>\n      \u003Cul class=\"material-colon-cancer-guide-list\">\n        \u003Cli>\n          \u003Cstrong>粪便潜血试验：\u003C/strong>\n          不用进医院，采集少量大便就能检验是否有隐性出血。阳性后需进一步肠镜排查。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>结肠镜检查：\u003C/strong>\n          直观看到肠道内的异常，并可活检确定性质。多数病例都需要这一环节。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>影像学检查：\u003C/strong>\n          如腹部CT、MRI，可了解肿瘤大小和有无转移。如果病例中出现多发转移，例如上述55岁男士出现腹膜转移，CT和基因检测一起能给医生提供更多信息（Van Cutsem et al., 2016）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>血液检测：\u003C/strong>\n          包括肿瘤标志物（如CEA、CA19-9等），配合临床情况作为辅助判断。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>基因分型：\u003C/strong>\n          对于晚期或复发病例，通过检测KRAS/NRAS/BRAF等基因，有助于指导后续的个体化治疗。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cdiv class=\"material-colon-cancer-guide-reminder\">\n        \u003Cspan>🔬\u003C/span> 一旦怀疑是肠癌，不要害怕检查，很多结论只有查清楚才能得到真正的答案。\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 05 当前有哪些有效的治疗方案？ -->\n  \u003Csection class=\"material-colon-cancer-guide-section\" style=\"background: linear-gradient(100deg, #f9f7fa 60%, #eee3f4 100%);\">\n    \u003Ch2 class=\"material-colon-cancer-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">05 如何选择结肠癌的治疗方法？\u003C/h2>\n    \u003Cdiv class=\"material-colon-cancer-guide-content\">\n      \u003Cp>\n        目前结肠癌的治疗最主要还是“综合方案”，医生会根据实际分期、病理类型、身体状况来决策。不同阶段采取的措施差别不小。可以简单分为三大类：\n      \u003C/p>\n      \u003Cul class=\"material-colon-cancer-guide-list\">\n        \u003Cli>\n          \u003Cstrong>手术治疗：\u003C/strong>\n          对于早期患者，用切除肿瘤及附近一段结肠的方式，能有效“清除”局部病灶。部分情况还需配合淋巴结清扫。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>化疗与放疗：\u003C/strong>\n          如果肿瘤较大或者已经有转移，化疗和放疗能帮助缩小病灶、控制扩散，为手术创造条件或者单独延缓病情进展。如前述那位55岁的男士，在手术后通过FOLFOX方案联合靶向化疗，有利于防止复发与控制转移灶发展。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>靶向及免疫治疗：\u003C/strong>\n          针对某些特定分子异常（如KRAS、NRAS野生型），可以用靶向药物“定点打击”肿瘤。近期免疫治疗也成为部分患者的新选择，尤其对某些基因异常的肿瘤效果突出（Overman et al., 2017）。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>\n        除了积极治疗，临床医生还会结合营养、心理干预、康复训练进行综合照护。患者家庭的支持同样重要，能更好地完成整个治疗过程。\n      \u003C/p>\n      \u003Cdiv class=\"material-colon-cancer-guide-reminder\">\n        \u003Cspan>💡\u003C/span> 治疗不只是针对癌细胞，也要关注生活质量和恢复能力。如果遇到疑问，一定要和熟悉的肿瘤科医生多沟通。\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 06 如何在日常生活中预防结肠癌？ -->\n  \u003Csection class=\"material-colon-cancer-guide-section\" style=\"background: linear-gradient(100deg, #f4f9fa 60%, #e3f4ee 100%);\">\n    \u003Ch2 class=\"material-colon-cancer-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">06 日常里怎么才能预防结肠癌？\u003C/h2>\n    \u003Cdiv class=\"material-colon-cancer-guide-content\">\n      \u003Cp>\n        大部分结肠癌其实都是和生活方式相关。要说预防的门道，也很简单，就是把身体状态调整到健康的“轨道”上来。\n      \u003C/p>\n      \u003Cul class=\"material-colon-cancer-guide-list\">\n        \u003Cli>\n          \u003Cstrong>多吃蔬菜水果：\u003C/strong>\n          蔬菜水果富含纤维素，有助于肠道蠕动，降低肠道被刺激的风险。建议每天有一半以上主食以蔬菜为主，同时搭配新鲜水果。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>保持规律运动：\u003C/strong>\n          每周至少150分钟的适度运动，比如快步走、游泳、慢跑，都能让身体代谢顺畅，对于肠道健康是“有好处”的小习惯（Wolin et al., 2009）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>常规体检和肠道筛查：\u003C/strong>\n          40岁以后，尤其有家族史的人，建议去医院做一次肠镜或粪便潜血检测。一些地区的社区医院也会有便捷的筛查服务。早发现比“有病才查”要有效得多。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>保持合理体重：\u003C/strong>\n          体重控制在合适范围，不但有助于心血管健康，对减少肠道肿瘤风险同样有益。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>情绪管理：\u003C/strong>\n          长期压力过大、情绪波动，不仅容易影响肠道功能，也可能削弱身体免疫力。因此，放松和良好的人际关系同样是健康生活的重要部分。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cdiv class=\"material-colon-cancer-guide-reminder\">\n        \u003Cspan>🥦\u003C/span> 简单说，膳食多样化、适当活动、定期体检，是帮肠道健康“打地基”。如果感觉身体出现不适，就不要“扛一扛”，早点咨询医生准没错。\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003Cdiv class=\"material-colon-cancer-guide-reference\" style=\"background: #f6f8fa; margin-top:32px; border-radius:12px; padding:16px 36px;\">\n    \u003Ch3 class=\"material-colon-cancer-guide-ref-title\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">参考文献\u003C/h3>\n    \u003Col class=\"material-colon-cancer-guide-ref-list\">\n      \u003Cli>\n        World Health Organization. (2023). \u003Cem>Colorectal cancer. Fact sheet\u003C/em>. Retrieved from https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer\n      \u003C/li>\n      \u003Cli>\n        Lynch, H. T., Snyder, C. L., Shaw, T. G., Heinen, C. D., Hitchins, M. P. (2015). Milestones of Lynch syndrome: 1895-2015. \u003Cem>Nature Reviews Cancer\u003C/em>, 15(3), 181–94.\n      \u003C/li>\n      \u003Cli>\n        Jess, T., Gamborg, M., Matzen, P., Munkholm, P., Sørensen, T. I. A. (2012). Increased risk of intestinal cancer in Crohn's disease: a meta-analysis. \u003Cem>Alimentary Pharmacology & Therapeutics\u003C/em>, 25(6), 647–56.\n      \u003C/li>\n      \u003Cli>\n        Van Cutsem, E., Cervantes, A., Nordlinger, B., Arnold, D. (2016). Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. \u003Cem>Annals of Oncology\u003C/em>, 27(suppl 5), v16–v24.\n      \u003C/li>\n      \u003Cli>\n        Overman, M. J., Kopetz, S., McDermott, R. S., et al. (2017). Nivolumab in patients with metastatic DNA mismatch repair-deficient or microsatellite instability-high colorectal cancer (CheckMate 142): an open-label, multicentre, phase 2 study. \u003Cem>Lancet Oncology\u003C/em>, 18(9), 1182–1191.\n      \u003C/li>\n      \u003Cli>\n        Wolin, K. Y., Yan, Y., Colditz, G. A., Lee, I. M. (2009). 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