胃癌根治术后迟发性大出血3例临床分析及防治策略  

Clinical characteristics of and prevention strategies for delayed hemorrhage following radical gastrectomy for gastric cancer

作　　者：李龙龙 李俊[1] Long-Long Li;Jun Li(Department of Gastroenterological Surgery,Deyang People’s Hospital,Deyang 618000,Sichuan Province,China)

机构地区：[1]德阳市人民医院胃肠外科,四川省德阳市618000

出　　处：《世界华人消化杂志》2020年第15期740-744,共5页World Chinese Journal of Digestology

摘　　要：背景胃癌(gastric cancer,GC)手术后延迟大出血在临床上是罕见的,但一旦发生就非常危险.病例简介回顾近期我院3例GC D2根治术后迟发性大出血患者的临床资料,结合相关文献报道,分析原因、治疗方案的利弊并总结相关治疗经验,提出防治策略.结论GC根治术后迟发性大出血原因复杂多样,死亡风险高,合并吻合口瘘及术区大血管损伤为主要原因,一经发现应立即行胃镜、计算机断层扫描、数字剪影血管成像等检查明确出血部位,并快速给予有效的止血措施,强调术前准备充分、术中规范精细操作、术后密切监测及有效支持是减少出血相关并发症的有效措施.BACKGROUND Delayed massive hemorrhage after gastric cancer surgery is clinically rare,but it is very dangerous once it occurs.CASE SUMMARY The clinical data of three patients who underwent radical gastrectomy for gastric cancer were retrospectively analyzed and the preventive strategies for this rare condition are summarized.CONCLUSION The causes of hemorrhage after radical gastrectomy are complicated and the methods of hemostasis should be flexibly chosen according to different causes.Computed tomography,digital substraction angiography,and endoscopy can be used for diagnosis and treatment.Intraoperative meticulous manipulation and postoperative close monitoring and effective support are essential for reducing delayed massive hemorrhage after gastric cancer surgery.

关 键 词：胃癌根治术 迟发性大出血 防治策略 

分 类 号：R735.2[医药卫生—肿瘤]