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目的探讨胃癌并幽门梗阻时TNM分期的临床特点,以指导诊治及判断预后。方法按国际抗癌联盟TNM分期及补充规则,对78例胃癌并幽门梗阻进行临床分析。结果T4N2M1病例占64.1%,早、中期胃癌梗阻时间平均为12.1d,晚期胃癌梗阻50.5d,差异有统计学意义(P<0.01)。上腹部扪及肿块35例,其中34例为Ⅳ期,另1例为Ⅲb期。结论胃癌并幽门梗阻绝大部分为癌症晚期。幽门梗阻可能促进胃癌发展,时间越长,越有可能发展至晚期。胃癌并幽门梗阻超过1个月,上腹部扪及肿块者,大部分为胃癌晚期患者,可作为临床诊断分期指标。应尽早手术治疗,解除梗阻,延长患者生命。
Objective To investigate the clinical features of TNM staging in gastric cancer with pyloric obstruction to guide the diagnosis and prognosis. Methods According to the International Union Against Cancer (TNM) staging and supplementation, 78 cases of gastric cancer with pyloric obstruction were analyzed. Results T4N2M1 cases accounted for 64.1%, early gastric cancer obstruction average 12.1d, advanced gastric cancer obstruction 50.5d, the difference was statistically significant (P <0.01). Upper abdomen palpable mass in 35 cases, of which 34 cases of stage Ⅳ, and the other 1 case of stage Ⅲ b. Conclusion Gastric cancer and pyloric obstruction most of the late stage of cancer. Pyloric obstruction may promote the development of gastric cancer, the longer the more likely to develop to late. Stomach cancer and pyloric obstruction for more than 1 month, upper abdomen palpable mass, most of the patients with advanced gastric cancer can be used as a clinical diagnosis of staging indicators. Surgical treatment should be as soon as possible to lift the obstruction and prolong the life of patients.