胃癌急性穿孔临床治疗体会

摘要

目的：探讨胃癌急性穿孔的临床特点及治疗方法的选择。方法：回顾性分析笔者所在医院36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：本组10例行胃癌根治术，18例行姑息性胃切除术，8例仅施行单纯穿孔修补加活检。行单纯穿孔修补的患者平均生存期为4.5个月，行姑息性胃大部切除术的患者平均生存期为14.5个月，而行根治性手术的患者平均生存期为23个月，其中1例已随访4年，生存质量良好。本组无死亡病例。结论：胃癌穿孔患者多数为晚期，一旦发生应积极治疗，选择合理的治疗方式和加强围手术期的处理能减少并发症及死亡率的发生，提高患者生存期。根治性胃切除和姑息性胃切除是首选且安全的手术方式。%Objective:To discuss clinical characteristics and treatment choices for gastric cancer with acute perforation.Method:The clinical data and surgical methods of 36 patients with perforated gastric cancer were analyzed retrospectively and evaluated.Result:10 patients were given radical resection,18 patients were given palliative gastrectomy,8 patients were given gastric perforation repair simple treatment and biopsies.The average survival time of the patients given radical resection,palliative gastrectomy and simple perforation repair were respectively 23 months,14.5 months and 4.5 months.One of them was followed for four years,and there was not a case of death.Conclusion:Patients with perforated gastric cancer were mostly at the later stage,so doctors should give an active treatment.Chooseing reasonable treatment and strengthening the perioperative management can decrease the complications and mortality of them,and then prolong the survival time.Radical gastrectomy and palliative gastrectomy are the first and safe surgical ways.