胃癌急症及其手术对策探讨

Emergencies of gastric cancer and its operative treatments.

目的总结胃癌合并急性幽门梗阻和出血的急诊手术经验。方法回顾性分析我院收治的胃癌合并性幽门梗阻和大出血的24例病人资料,探讨胃癌病人的急诊手术时机及诊治方法。结果24例病人均经过手术治疗,全部度过围手术期,无围手术期死亡。症状缓解,术后进食量增加,营养状况明显改善,延长了生存时间,提高了生存率。结论从诊断及治疗效果来讲,剖腹探查术及个体化的手术方案仍是胃癌并发急症时的重要诊治手段。

Objective To summarize the experiences in emergency operation for acute pyloric obstruction and major bleeding complicated in patients with gastric cancer. Methods Data about pyloric obstruction and major bleeding complicated in 24 patients with gastric cancer were retrospectively analysed to investigate their operative treatment methods. Results Operations were performed on all the 24 patients without perioperative death. After operations, symptoms were relieved, nutritional status and survival rate improved. The success rate of operations were up to 100% with a series of remedies, including gastric and intestinal decompression, anti-infection treatment, correction of disturbance of water, electrolyte and acid-base balance, venous nutritional support, transfusing blood, antishock treatment etc. Conclasion From the viewpoint of diagnosis and treatment, exploratory laparotomy and individualized operation treatment methods are key to the successful management of acute complications of gastric cancer.