摘要
目的 探讨胃癌穿孔的诊治方法。方法 回顾性分析 43例经病理证实的胃癌穿孔的临床资料。结果 术前诊断率为 30 .2 % (13例 ) ,误诊率 6 9.8% (30例 ,包括术中误诊 2例 )。单纯修补缝合术 2 1例 ,术后早期死亡 4例 (19.1% )、术后发生呕血、黑便 8例(38.1% )、再穿孔 3例 (1.4% ) ,平均生存期 5个月 ;胃肿瘤姑息性切除术 9例 ,术后早期死亡 1例、呕血 1例 ,平均生存期 18个月 ;胃癌根治术 13例 ,无近期并发症 ,平均生存期 2 7个月 ,5年生存率 2 3.1% (3 13)。 2例误诊者先行穿孔修补术 ,再手术时发现广泛转移 ,失去手术机会。结论 术前全面综合临床分析 ,术中注意胃癌穿孔的征象 ,可提高本病的诊断率 ;单纯修补术近期并发症多 ,平均生存期短 ;术中一旦明确胃癌穿孔 。
Objective To study the diagnosis and treatment of perforated gastric cancer(PGC). Methods The clinical data of 43 patients with PGC proved pathologically were analysed retrospectively; Results The diagnosis rate preoperatively was 30.2%(13 cases), misdiagonsis rate 69.8% (30 cases, including 2 misdiagonsed intraoperatively); 21 underwent simple suture closure of the perforation, among whom, 4 died (19.1%), 8 had hematemesis and melanorragia (38.1%), 3 reperforation (1.4%) after operation; mean survival period was 5 months. 9 cases had palliative gastrectomy, 1 died, while 1 had hematemesis after operation; mean survival period 18 months. 13 cases had radical gastrectomy, none of them had postoperative complication or death, mean survival period 27 months, 3 surrived for 5 years(23.1%). 2 delyed diagnosis underwent simple suture closure at first, but had extensive metastasis at reoperation. Conclusions Comprehensive analysis of clcnical data made before operation and attenton paid to the signs of PGC during operation can enhance the diagnosis rate of PGC. Simple suture closure of the perforation has more complications, and the survival time is shorter . Once PGC gastric cancer is diagnosed , radical or palliative gastrectomy should be performed.
出处
《中国普通外科杂志》
CAS
CSCD
2001年第3期200-202,共3页
China Journal of General Surgery
