胃癌大出血26例临床分析

Diagnosis and management of massive bleeding in patients with gastric cancer： Analysis of 26 cases

目的探讨胃癌大出血的临床特点及其诊治方法。方法回顾性分析26例胃癌大出血病人的临床资料。结果胃癌大出血的临床特点主要表现为：呕血，排柏油样大便或暗红色血便，约半数病例可出现失血性休克征象。26例均经纤维胃镜检查确诊为胃癌，其中限期手术22例，急诊手术3例，放弃手术1例。26例中，治愈出院25例，死亡1例。结论胃癌大出血病人一般经非手术治疗可以有效止血，少数出血严重、经非手术治疗无效的病人需急诊行手术治疗。纤维胃镜检查是该病诊断有效方法及止血的有效措施，手术是首选的治疗方法。

Objective To investigate the clinical features, diagnoses and treatments of gastric cancer with massive bleeding. Methods The clinical data of 26 patients with gastric cancer with massive bleeding were analyzed retrospectively. Results The frequent presentation was vomiting with blood,tar-stool and even shock. All 26 patients accepted upper gastrointestinal endoscopy and diagnosed as having gastric cancer： 22 patients received limited operation, 3 received emergency operation, and one given up the operation. Twenty-five patients were cured and one died. Conclusion For most of patients with gastric cancer massive bleeding can be arrested by conservative treatment, and the few with serious bleeding need emergency operation. Upper gastrointestinal endoscopy is the effective means to diagnose and stop bleeding. Surgery is the preferred treatment.