个体化原则在胃癌合并门静脉高压症治疗中的应用

The application of the individual principle in the treatment of gastric cancer complicated with portal hypertension

目的:探讨个体化原则在胃癌合并门静脉高压症(portal hypertension,PHT)患者手术方式选择和围手术期处理中的应用。方法:对18例应用个体化原则治疗的胃癌合并PHT患者临床资料进行回顾性分析,其中行D2根治手术17例,姑息性切除1例;同时行脾切除加贲门周围血管离断术6例,脾切除术8例。结果:16例出现不同程度腹水,2例发生腹腔内出血,1例并发腹腔脓肿,1例并发切口感染,1例发生切口裂开,经积极治疗后均痊愈。结论:胃癌合并PHT手术复杂、根治困难、术后并发症多,但遵循个体化原则选择手术方式和围手术期治疗,同时处理两种疾病是可行的。

Objective：To explore the application of individual operation and perioperation period processing in the treatment of gastric cancer complicated with portal hypertension（PHT）. Methods：The clinical data of 18 patients with gastric cancer complicated with PHT treated with individual treatment were retrospectively analysed. Seventeen cases were treated with D2 radical operation, 1 case was treated with palliative resection, 6 cases were treated with splenectomy combined with perieardial devascularization, and 8 cases were treated with splenectomy. Results： Ascites in 16 cases, intra-abdominal hemorrhage in 2 cases, intra-abdominal abscess in 1 case, incision infection in 1 cases and wound dehiscence in 1 case were found. All patients recovered after active treatment. Conclusions：The operation,treatment and postoperative complications in patients with gastric cancer with PHT are complex, difficult and more. The individual operation and perioperation period processing in the treatment of gastric cancer complicated with PHT are feasible.