胃癌急性穿孔的诊断与治疗

Diagnosis and treatment of acute tumorous gastric perforation

目的探讨胃癌急性穿孔的临床特点及其诊治方法。方法回顾性分析23例胃癌急性穿孔患者的临床资料。结果单纯穿孔修补术6例，穿孔修补加胃空肠吻合术4例，穿孔修补术后行二期根治手术2例；姑息性胃癌切除术8例；一期胃癌根治术3例。三种术式的平均生存期分别为8．5个月，13．6个月和23个月。结论早期诊断及选择正确术式是降低病死率的重要因素，应尽可能行根治术或姑息性胃大部切除术。

Objective To investigate the clinical features, diagnosis and treatment of acute tumorous gastric perforation. Methods The clinical data of twenty-three patients suffered from acute tumorous gastric perforation were analyzed retrospectively. Results There were 6 cases treated with simple perforation repair, 4 cases underwent perforation repair and gastrojejunostomy anastomosis, 2 cases underwent radical gastrectomty after perforation repair, with 8.5 months of average survival time, 8 cases underwent palliative subtotal gastrectomy with 13.6 months of average survival time, and 3 cases underwent radical gastrectomty with 23 months of average survival time. Conclusions Early diagnosis and suitable surgical method were the important factors to decrease the mortality incidence and increase the life quality. Radical and palliative gastrectomy is the first choice of surgical method.