胃癌合并急性消化道大出血的处理和手术策略探讨  

Discussion on Surgical treatment of gastric cancer with acute gastrointestinal hemorrhage

作　　者：束翌俊 杨自逸 刘颖斌 董平[1] Shu Yijun;Yang Ziyi;Liu Yinbin;Dong Ping(Department of General Surgery and Laboratory of General Surgery,Xinhua Hospital,Affiliated with Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Institute of Biliary Tract Disease,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院普外科,上海市胆道疾病研究中心,上海交通大学医学院胆道疾病研究所,200092 [2]上海交通大学医学院附属仁济医院普外科

出　　处：《中华普外科手术学杂志（电子版）》2021年第2期224-227,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金青年项目(31701108);上海市“医苑新星”青年医学人才培养资助计划(沪卫计人事[2019]72号)。

摘　　要：胃癌合并急性消化道大出血是进展期胃癌的危重急症之一。术前应在保证患者生命体征的情况下经消化内科、外科、药学、放射介入科和重症医学科等多学科会诊全面评估肿瘤分期和可切除性。内镜检查是胃癌合并急性大出血的主要确诊手段及重要治疗方式。外科手术是非手术疗法效果不佳或失败后的唯一补救方法,手术方式应根据肿瘤位置,分期适当选择,联合多脏器切除的扩大根治术对患者的收益值得进一步探索和积累经验。Gastric cancer with acute hemorrhage is one of the criticalhallenging emergency of advanced gastric cancer.Preoperative Tumor staging and resectability should be fully evaluated by mMulti-disciplinary discussions including Gastroenterology,Surgery,Pharmacy,Radiological Intervention and Intensive care Medicine before surgery should be conducted to comprehensively evaluate tumor staging and resectability under the condition of ensuring the patient's vital signs.to ensure the patient's vital signs.Endoscopy is effective in diagnosing and treating of gastric cancer with acute massive hemorrhage.Surgical surgery is the only remedy for poor or failed non-surgical therapy,and Some patients required surgical treatment when it was impossible to achieve hemostasis by pharmacotherapy and endoscopy or if rebleeding occurred where the conservative treatment had failed,surgical treatment should be appropriate selected base on the location of tumor and staging.The benefits of extended radical mastectomy combined with multiple organ resection are worth further exploration and experience.

关 键 词：胃肿瘤 出血 外科手术 急性消化道大出血 

分 类 号：R73[医药卫生—肿瘤]