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目的 探讨改善手术治疗胃癌穿孔患者预后的方法.方法 回顾分析1983～1997年收治的17例胃癌穿孔患者的治疗结果.结果 16例手术治疗,9例行远端胃大部切除术,切除率56%(其中5例为R2根治术,根治切除率56%);5例行穿孔修补术;胃造瘘和2次剖腹探查各1例.手术早期死亡3例,其中2例为穿孔修补,1例为远端大部切除术.随访11例,1年内死亡7例,2年内死亡1例,3例存活3年以上.结论 对胃癌穿孔应采取积极治疗,根治性手术病死率低于单纯修补术,且有利于延长患者生存期.
Objective To explore the methods to improve the prognosis of surgical treatment of perforated gastric cancer patients. Methods The retrospective analysis of the treatment results of 17 patients with perforation of gastric cancer from 1983 to 1997. Results 16 cases of surgical treatment, 9 cases of distal gastrectomy, resection rate 56 % (of which 5 were R2 radicals, radical resection rate 56%); 5 cases perforation repair; gastrostomy and 2 cases of laparotomy in 1 case each. 3 cases died early in surgery, including 2 cases of perforation repair, 1 In the case of distal subtotal resection, 11 cases were followed up, 7 died within 1 year, 1 died within 2 years, 3 cases survived for more than 3 years. Conclusion Positive treatment should be taken for perforation of gastric cancer, the mortality rate of radical surgery is lower than that of pure repair. Surgery, and help to extend the survival of patients.