胃癌并穿孔病例临床分析

Clinical analysis in the patients with gastric cancer with perforation

目的探讨胃癌并穿孔的病因、诊断及治疗。方法回顾性分析我院1995年—2007年间收治的10例患者临床资料并进行总结。结果 9例以突发性上腹部疼痛入院,1例全腹痛,右下腹明显入院;术前疑诊胃癌穿孔3例,术中确诊3例,误诊消化系溃疡穿孔3例,误诊急性阑尾炎1例;穿孔修补术6例,其中单纯穿孔修补3例,穿孔修补+胃空肠吻合术2例,穿孔修补+空肠造瘘术1例,并于术后4周行Ⅱ期根治手术;胃切除4例。术后最长生存4.5年,最短11个月,平均生存23个月。修补术4例,生存期4个月～12个月,平均生存7.5个月。结论胃癌穿孔是晚期胃癌的一种急性严重并发症。提高认识,避免误诊,采取适宜的手术方式是提高疗效的关键。

Objective To study the diagnosis and treatment of gastric cancer with perforation.Methods The clinical data of ten patients with perforated gastric cancer that were treated in surgery department of Huicheng Hospital from 1995 to 2007 were investigated retrospectively.Results 6 patients underwent repair of perforation,3 cases were treated with repair of perforation,2 with repair of perforation and gastrectomy at the same time,1 with repair of perforation and jejunostomy at the same time,which with radical gastrectomy for gastric cancer after repair of perforation about four weeks.The longest survival time of the patients treated with gastrectomy was 4.5 years,while the shortest survival time was 11 months.The medial survival time was 23 months.The longest survival time of the patients treated with repair of perforation was 12 months,while the shortest survival time was 4 months.The medial survival time was 7.5 months.Conclusion Reasonably select surgery method and positive treatment are keys to prolong the survival time.