胃癌并肝硬化患者行根治术后腹水的处理  

Management of ascites after radical surgery in gastric cancer patients with liver cirrhosis

作　　者：刘金彪[1] 杨俊川[1] 丁斌[1] 

机构地区：[1]河南科技大学第一附属医院普外三科,471000

出　　处：《中国临床实用医学》2010年第7期29-30,共2页China Clinical Practical Medicine

摘　　要：目的探讨胃癌合并肝硬化患者行根治术的安全性和腹水的处理。方法回顾性分析26例胃癌合并肝硬化患者围手术期情况。结果本组患者围手术期无死亡，术前肝脏功能评级Child．Pugh均为A级，其中行D2淋巴结清扫25例（96．2％），切除淋巴结数目平均（33±11）个，12例术后放置了腹腔引流（46．2％），平均引流量为463ml／d，平均拔出引流天数为11d，8例患者应用了利尿剂（30．8％）。结论胃癌根治术时行较广泛的淋巴结清扫术，对胃癌合并肝硬化患者是安全的，对手术前及术后腹水应用利尿剂治疗是有效的。Objective To evaluate the safety of radical lymph node dissection on gastric cancer patients with liver cirrhosis and management of ascites. Methods A radical lymph node dissection on 26 gastric cancer patients with liver cirrhosis（LC） were reviewed retrospectively. Results Child-Pugh status was grade A in all 26 patients, and a D2 lymph nodes dissection was performed in 25 （96. 2% ）patients. The mean number of dissected lymph nodes was 33 ± 11. An abdominal drain was placed in 12 （46. 2% ）patients, and the average amount of fluid drainage was 463 mL/d. The drainage tube was removed on about days, and diuretics were used in 8（30. 8% ）patients. Conclusion An extended lymph node dissection is safe in gastric cancer patients with mild LC. Liver cirrhosis and postoperative ascites can be managed conservatively without any complications.

关 键 词：胃癌 肝硬化 胃癌根治术 腹水 

分 类 号：R575[医药卫生—消化系统] R735[医药卫生—内科学]