胃癌急性穿孔手术方案的选择及效果  

Selection and efficacy assessment of surgical program for gastric cancer with acute perforation

作　　者：汤兴华[1] 刘雄[1] 章宜兰[1] 鲁明骞[2] 文彩虹[2] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院急诊科,宜昌443003 [2]三峡大学第一临床医学院宜昌市中心人民医院肿瘤科,宜昌443003

出　　处：《中国肿瘤临床与康复》2015年第5期562-564,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨胃癌急性穿孔手术方案的选择及效果。方法回顾性分析收治的80例胃癌急性穿孔患者的临床资料，其中姑息性胃切除手术组38例，根治性胃切除手术组42例，比较两组患者的手术效果。结果所有患者均手术成功，且两组患者住院时间和并发症发生率比较，差异无统计学意义（P〉0．05）。随访12～36个月，根治性胃切除手术组和姑息性胃切除手术组患者的1年生存率分别为86．8％和85．7％，差异无统计学意义（P〉0．05），但根治性胃切除手术组患者的2年生存率为69．0％，明显高于姑息性胃切除手术组的52．6％，根治性胃切除手术组死亡患者的生存时间明显长于姑息性胃切除手术组，差异有统计学意义（P〈0．05）。术后6个月，两组患者的生活质量（QOL）评分与术前比较均显著提高，差异有统计学意义（P〈0．05）。结论胃癌急性穿孔患者姑息性胃切除和根治性胃切除手术的临床效果满意，可以较好地改善患者的生活质量。如患者机体情况允许，应积极实施根治性胃切除手术，以提高生存时间。Objective To investigate the selection and efficacy assessment of surgical program for gastric cancer with acute perforation. Methods From June 2011 to June 2012 in Yichang Central People＇s Hospital, the clinical data of 80 patients of gastric cancer with acute perforation were analyzed retrospective- ly. 38 cases were treated with palliative gastrectomy （palliative gastreetomy group）, and 42 cases were trea- ted with radical gastreetomy （radical gastrectomy group）. The treatment efficacy of the two groups were compared and analyzed. Results All surgery were successful. The length of hospital stay, incidence of complications of two groups showed no significant difference （P 〉 O. 05 ） ; followed-up 12 to 36 months, the 1 year survival rates of palliative gastrectomy group and radical gastreetomy group were 86. 8% , 85.7% , and there was no significant difference （ P 〉 O. 05 ）, but the 2 years survival rate of radical gastrectomy group was 69. 0% , significantly higher than 52. 6% of palliative gastrectomy group, and the mean survival time of died patients of radical gastrectomy group was significantly longer than the palliative gastrectomy group, and there were significant differences between two groups （ P 〈 O. 05 ） ; the quality of life （QOL） scores of patients in 6 months after surgery of two groups were significantly improved, and there was signifi- cant differences compared with before surgery （ P 〈 0.05 ）. Conclusions Palliative gastrectomy and radical gastrectomy in the treatment of gastric cancer with acute perforation has satisfactory clinical results, can greatly improve the QOL of patients. But if the patient body conditions permit radical gastrectomy surgery should applied to improve survival.

关 键 词：胃肿瘤 急性穿孔 姑息性胃切除手术 根治性胃切除手术 

分 类 号：R735.2[医药卫生—肿瘤]