老年人胃癌急性穿孔手术方式的探讨

Treatment of Acute Perforation of Gastric Cancer in Gerontism Patients

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38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13例,平均生存时间为7个月;姑息性胃大部切除术17例,平均生存时间为18个月;胃癌根治术7例,平均生存时间24个月。结论:提高术前、术中确诊率,根据患者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、降低老年胃癌穿孔的并发症、延长患者生存时间、提高生存质量的关键。

Objective： To explore the clinical characteristics and different operative options for acute perforated gastric carcinoma （APGC） in gerontism patients, to improve the diagnosis, treatment and prognosis of APGC. Methods： The clinical data of thirtyeight gerontism patients with gastric cancer perforation were analyzed retrospectively. Results： Thirteen cases received simple suture with average survival time of seven months, seventeen cases received palliative subtotal gastrectomy with the average survival time of eighteen months, and seven radical gastrectomy with the average survival time ＇of twenty-four months, Conclusion： The critical proeedure for patient＇ s safety, lower morbidity of complications, prolonged survival time and better life quality is to raise the rate of confirmed diagnosis before and during the surgical operation,strengthen the perioperative management and to select the relevant operative options.