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目的探讨胃癌急性穿孔的临床特点以指导临床诊治,提高其疗效。方法回顾性调查宁波第一医院1998～2007年间在外科治疗的35例胃癌穿孔患者的临床资料,分析手术术式与生存期的相关性。结果大体类型多为溃疡型(28/35例,80%),病理多为低分化或未分化癌(27/35例,77.1%)。单纯穿孔修补术(或加胃空肠吻合术)11例,姑息性胃大部切除术13例,胃癌根治术11例。术后并发症发生率51.42%,手术死亡率5.7%,穿孔修补、姑息性切除、根治性切除术后1,3,5年生存率分别为9.09%、0%、0%;61.53%、30.79%、0%;81.81%、63.63%、36.36%。结论提高术前、术中确诊率,根据患者情况选择合适的术式很重要,首选行根治术或姑息性胃大部切除术。
Objective To investigate the clinical features of acute gastric perforation in order to guide clinical diagnosis and treatment and improve its curative effect. Methods The clinical data of 35 patients with gastric cancer perforation who were surgically treated in Ningbo First Hospital from 1998 to 2007 were retrospectively analyzed. The correlation between operative procedure and survival was analyzed. Results Most of the types were ulcerative (28/35 cases, 80%), mostly poorly differentiated or undifferentiated (27/35 cases, 77.1%). Simple perforation repair (or gastrojejunostomy) in 11 cases, palliative gastrectomy in 13 cases, radical gastrectomy in 11 cases. The postoperative complication rate was 51.42%, operative mortality rate was 5.7%, perforation repair, palliative resection and postoperative 1, 3, 5 year survival rates were 9.09%, 0%, 0%, 61.53%, 30.79 %, 0%; 81.81%, 63.63%, 36.36%. Conclusion To improve the preoperative and intraoperative diagnosis rate, according to the patient’s condition is very important to choose the appropriate surgical treatment, or the preferred radical gastrectomy.