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本文报告经手术和病理证实的胃癌急性穿孔38例,占同期手术治疗胃急性穿孔的15.9％,与胃溃疡急性穿孔的比率为1∶4.9。胃癌急性穿孔术前确诊困难,易误诊为胃溃疡急性穿孔,本组术前诊断者仅4例(10.5％)。术中所见和取材活捡对提高正确诊断率很有帮助,本组术中诊断者22例(57.8％),经病理最后确诊者16例。(42.2％)。胃癌急性穿孔应争取一期手术切除或穿孔修补后短期内再次手术切除。本组仅,7例(18.4％)行胃切除,手术切除率不高的原因,部分是因为将胃癌穿孔误诊为胃溃疡穿孔,或认为是否行胃切除对改善胃癌穿孔的预后影响不大,因而忽视了施行胃切除的重要性。
This article reports 38 cases of gastric cancer acute perforation confirmed by surgery and pathology, which accounted for 15.9% of acute gastric perforation in the same period of operation, and the ratio of acute perforation of gastric ulcer was 1:4.9. The diagnosis of gastric cancer before acute perforation is difficult, and it is misdiagnosed as acute perforation of gastric ulcer. Only 4 cases (10.5%) were diagnosed before surgery in this group. Intraoperative findings and drawing live lice are helpful to improve the correct diagnosis rate. In this group, 22 cases (57.8%) were diagnosed intraoperatively, and 16 cases were confirmed by pathology. (42.2%). Acute perforation of gastric cancer should strive for a surgical resection or perforation repair and re-surgery in the short term. In this group, only 7 cases (18.4%) underwent gastrectomy. The reason for the low rate of surgical resection was partly because the perforation of gastric cancer was misdiagnosed as perforation of gastric ulcer, or whether the resection of gastrectomy had little effect on improving the prognosis of gastric perforation. Thus neglected the importance of the implementation of gastrectomy.