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目的探讨胃癌根治术后腹腔出血的原因、再次手术的指征及预防措施。方法2001—2015年我科行胃癌根治术患者1631例,术后并发腹腔出血26例。后者保守治疗6例;再次手术20例,其中出血血管结扎或缝扎17例,后又行血管介入栓塞治疗2例;创面渗血处止血纱布压迫3例。结果保守治疗6例中,出血控制5例,死亡1例。再次手术20例中,出血控制18例,2例反复出血行血管介入栓塞治疗后治愈。结论胃癌根治术后腹腔出血与手术操作有密切关系。预防的关键是重视手术基本操作,加强围手术期处理。
Objective To investigate the causes of abdominal bleeding after radical operation of gastric cancer, indications for reoperation and preventive measures. Methods From 2001 to 2015, 1631 patients underwent radical gastrectomy in our department, with 26 cases of intra-abdominal hemorrhage. The latter conservative treatment in 6 cases; reoperation in 20 cases, of which 17 cases of bleeding vascular ligation or suture, followed by interventional vascular embolization in 2 cases; wound bleeding gauze stop bleeding gauze in 3 cases. Results In conservative treatment of 6 cases, bleeding control in 5 cases, 1 case of death. In 20 cases of reoperation, hemorrhage control was performed in 18 cases and in 2 cases repeated bleeding was cured after vascular interventional embolization. Conclusions Intraperitoneal bleeding after radical operation of gastric cancer is closely related to the operation. The key to prevention is to pay attention to the basic operation of surgery to enhance perioperative management.