胃癌穿孔的诊断与外科治疗  

Diagnosis and surgical treatment of perforation of gastric carcinoma

作　　者：赵玉生[1] 张吉发[1] 菅志飞[1] 戴宗晴[1] 王芳元[2] 

机构地区：[1]郧阳医学院附属东风医院胃肠外科,湖北十堰442008 [2]咸宁医学院附属医院普外科,湖北咸宁441500

出　　处：《中国现代医学杂志》2008年第6期757-759,共3页China Journal of Modern Medicine

摘　　要：目的探讨胃癌穿孔的诊断与外科治疗原则。方法回顾性分析25例胃癌穿孔患者的临床资料以及手术方式,并进行疗效评价。结果该组行穿孔修补术者10例,姑息性切除术11例,根治性切除术4例(其中6例穿孔修补术后4周左右,二期手术姑息性切除术5例、根治性切除术1例)。该组治愈21例,死亡4例(术后30d以内),死亡原因为穿孔修补处再穿孔和感染性休克导致多器官功能衰竭。术后生存期穿孔修补术者3～6个月;姑息性切除术为15～22个月;根治性切除术者为33～49个月。结论准确的诊断、合理的术式选择和加强围手术期的处理,对降低胃癌穿孔死亡率、并发症发生率,改善其预后有重要意义。治疗原则应积极手术,尽可能行根治或姑息手术切除病灶。[Objective] To discuss the diagnosis and surgical treatment principle of perforation of gastric carcinoma. [Methods] The clinical data and operation fashion of perforation of 25 gastric carcinoma patients. [Result] In the 25 patients,10 received the perforation repair operations were retrospectively analyzed （5 took the secondary pallihtive operations in the 6 eases 4 weeks after the perforation repair operations,1 took the cure resection operations）, 11 the palliative operations, 4 the resection. 21 patients were cured and 4 died within 30 days after operation）, the cause of death was MODS, which was caused by the reperforation on the repaired site and septic shock. The lifetime was 3-6 months in the cases who took the repair operations,15-22 months ih thoes with the palliative operations, 33-49 ih thoes with months the resection operations. [Conclusion]Exact diagnosis, reasonable choice of the operation fashion and to strengthening the perioperative management were significant to reduce the death as soon as possible rate, complications and improve the prognosis. To have operation positivly and to cure or palliatively resect the focus are the principles of treatment.

关 键 词：胃癌 胃癌穿孔 手术治疗 

分 类 号：R656.6[医药卫生—外科学]