老年人胃癌急性穿孔的治疗

Treatment of senile acute tumorous gastric perforation

目的探讨老年人胃癌急性穿孔的临床特点和不同术式的选择指征。方法回顾性分析收治的33例老年胃癌急性穿孔的临床资料。结果单纯穿孔缝合修补术11例,平均生存时间为7个月;姑息性胃大部切除术15例,平均生存时间为18个月;胃癌根治术6例,平均生存时间24个月。结论提高术前、术中确诊率,根据病人情况选择合适的术式,加强围手术期的处理是保障患者生命安全、降低胃癌穿孔的并发症、延长生存时间、提高生存质量的关键。

Objective To explore clinical characteristics and different operative options for acute tumorous gastric perforation in elderly patients and to improve the diagnosis, treatment and prognosis. Methods The clinical data of thirty-three senile patients with acute tumorous gastric perforation were retrospectively analyzed. Results There were 11 cases treated with simple suture with 7 months of average survival time, 15 cases with palliative subtotal gastrectomy with 18 months of average survival time, and 6 with radical gastrectomy with 24 months of average survival time. Conclusion It is important to raise the rate of confirmed diagnosis, strengthen the perioperative management and select the relevant operative options for senile patients with acute tumorous gastric perforation.