文档介绍：
胃癌穿孔的诊断和治疗
[摘要] 目的:探讨胃癌穿孔的临床特点、诊断要点和手术方式。方法:回顾2007年1月～2009年1月在我院住院治疗的35例胃癌穿孔患者的临床资料,并进行总结分析。结果:根治性胃癌切除术术后死亡1例,姑息性胃癌切除和胃癌穿孔修补术术后各死亡1例,死亡原因主要是多脏器功能衰竭,穿孔缝合后发生胃漏及严重腹膜炎。本组31例出院,获随访30例,单纯穿孔修补术存活时间14 d～10个月,平均(±)个月;穿孔修补加胃空肠吻合术存活时间3～14个月,平均(±)个月;姑息性胃大部切除术存活时间4～30个月,平均(±)个月;胃癌根治术平均8～30个月,平均(±)个月。结论:胃癌穿孔的临床特点复杂,熟练掌握其诊断要点并选择合理的手术方式具有重要的临床意义。
[关键词] 胃癌;穿孔;诊断;手术方式
[中图分类号] R735[文献标识码] B[文章编号] 1673-7210(2010)05(a)-187-02
Diagnosis and treatment of perforation in gastric cancer
HUANG Jinyuan, JIANG Jie, CAO Xizhao
(Nongken Central Hospital of Guangdong Province, Zhanjiang 524002, China)
[Abstract] Objective: To investigate the clinical features, main points of diagnosis and operation method. Method: Review the data of 25 cases with perforation in gastric cancer in our hospital from January in 2007 to January in 2009, and the data were analyzed. Results: 1 case of radical cure carcinectomy was dead, and there was 1 case dead in operation of palliation gastric cancer excision and neoplasty of gastric cancer respectively. The main causes of death were many organ nonfunction, leaks which happened after perforation were sewed up and aeverious peritonitis. There were 31 cases who were discharged and 31 cases were followed- survival time of merely palliation gastric cancer excision was 14 days to 10 months, and the average time was (±) months. The survival time of neoplasty of gastric cancer combined with gastrojejunostomy was 3 to 14 months, and the average time was (±) months. The survival time of palliation subtotal gastrectomy was 4 to 30 months, and the average time was (±) months. The survival time of radical cure carcinectomy was 8 to 30 months, and the average time was (±) months. Conclusion: The clinical feature of gastric cancer is multiplicity, it is important to grasp the main points of diagnosis and to choose the reasonable operation method.