胃癌急性穿孔的诊治分析

Analysis of diagnosis and treatment for acute perforation of gastric cancer

目的探讨胃癌穿孔的临床特点、诊断方法及手术方式。方法回顾性分析20例胃癌合并急性胃穿孔的临床资料以及手术方式。结果本组治愈16例,死亡4例,死于感染性休克伴多脏器功能衰竭。术后并发症:肺部感染3例,吻合口瘘3例,消化道出血2例。术后获得随访一年有16例,其中3例死亡,7例出现恶液质,其余6例暂未见复发。结论术中常规取标本活检测可避免胃癌漏诊。早期诊断及正确术式是降低病死率,提高生存质量的重要因素。强调尽可能施行一期胃癌根治术或姑息性胃切除,其生存期明显优于其它术式。

Objective To investigate the Clinical feature,diagnosis and operative manner of perforated gastric cancer.Methods 20 cases with perforated gastric cancer were analyzed retrospectively in the clinical data and operative manners.Results 16 cases were cured,4 cases died from septic shock accompanied with multiple organ dysfunction syndrome,MODS).Postoperative complications:pulmonary infection was in 3cases,anastomotic leakage in 3 Cases and hemorrhage of digestive tract in 2 cases.With follow up one year after discharge from hospital,3 cases died and cachexia was found in 7 cases and no recurrence was found in other cases. Conclusion If intraoperative biopsy was taken,the missed diagnosis of gastric cancer may be avoided.Eary diagnosis and Correct operative manner can reduce fatality rate and it is an important factors for improving the survival quality.Primary radical gastrectomy or palliative gastrectomy for cancer should be emphasized as far as possible.Its survival time is better than that other operative manners.