32例胃癌急性穿孔的诊治

Diagnosis and Treatment of Perforation of Stomach Cancer with 32 Cases

目的探讨胃癌急性穿孔的临床特点,指导临床诊治及提高疗效。方法对本院32例胃癌急性穿孔病人采用不同的手术方式进行治疗。4例行单纯穿孔修补术,其中2例于术后3～4周行二期根治性手术;5例行穿孔修补加胃空肠吻合术;10例行姑息性胃大部切除术;1例行胃造口术;12例行胃癌根治术。结果本组手术切除率为75%(24/32);死亡率9%(3/12)。术后5年、4年、3年、1年、半年生存率分别为9%(3/32)、3%(1/32)、6%(2/32)、40.6%(13/32)、21.9%(7/32)。分期手术2例疗效佳。结论早期诊断,综合治疗,可明显改善其预后,降低死亡率,提高生活质量。

Objective To investigate the clinical characteristics and give better guide to the diagnosis, therapy and improvement of the patients suffering from perforation of gastric cancer. Methods We summarized 32 cases suffering from perforation of gastric cancer in our hospital from 1978 to 2004. Of the patients,4 were treated with repair of perforation,2 with radical gastrectomy for gastric cancer after repair of perforation for about 3～4 weeks; 5 with repair of perforation and gestrojejunostomy at the same time;10 with partial gastrectomy; 1 with gastrectomy; 12 with radical gastrectomy for gastric cancer. Results: Surgical excision rate 75%(24/32);death rate 9%(3/32).The 5-,4-,3-,1-,1/2-years survival rates were 9%(3/32)、3%(1/32)、6%(2/32)、40.6%(13/32)、21.9%(7/32) respectively. Conclusion Early diagnosis and great attention to whole treatment are important factors to cut down the death rate and improve life quality.