胃癌并幽门梗阻的临床特点与手术效果分析

Analysis of Clinical Characteristic and Operation Effect of Gastric Cancer with Pyloric Obstruction

目的:分析胃癌并幽门梗阻患者的临床特点和手术效果,以指导诊治及判断预后。方法:对56例胃癌并幽门梗阻患者的临床特点和手术预后进行回顾性分析。结果:56例患者中Ⅳ期53例,Ⅲ期3例,伴远处转移21例。行根治性切除8例,姑息性切除17例,胃空肠吻合20例,剖腹探查取活检11例。术后2年以上生存率23.2%,5年生存率3.5%。结论:胃癌并幽门梗阻绝大部分为癌症晚期。但由于胃窦腔狭小,较小的瘤体亦可引起梗阻,故仍有根治性切除的可能,应尽量努力采取根治的术式,姑息性切除亦能延长生存期,个别病例还可生存5年以上;旁路手术也可减轻病人痛苦改善全身状况和提高生存质量。宜早期手术,合理治疗。

Objective: Analyse the clinical characteristic and operation effect of gastric cancer with pyloric obstruction, and give a better guide to the diagnosis, therapy and judgement of prognosis for the patients suffering from gastric cancer with pyloric obstruction. Method: We summarized 56 cases suffering from gastric cancer with pyloric obstruction. And studied clinical characteristic and operation effect. Result: Most of patients suffering from gastric cancer with pylorus obstruction advanced to later period . Among them 53 patients were in grade Ⅳ. 21 cases companion transfers in the distance. 2 years survival rate was 23.2%,5years survival was 3.5%. Conclusion: Gastric antrum is narrower. A little tumour may lead to obstructs. Therefore it is impossble to heal,we ought to do our best to ablate. appeasable operation might delay patient’s life. Some of them might exist morechan five years. gastric bypass could make them better. We ought to operate as quickly as possible.