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目的探讨胃癌急性穿孔的临床特征和治疗方法,以提高临床诊治水平。方法选择25例胃癌急性穿孔患者,其中4例癌细胞转移和9例腹腔严重污染者行单纯的穿孔修补术,7例行胃姑息性切除术,5例行胃根治性切除术。结果根据组织学分型,胃癌早期3例,未分化腺癌6例,低分化腺癌8例,中分化腺癌6例,印戒细胞癌2例。手术切除率为48.0%,且均治愈出院。结论胃癌急性穿孔通常在手术过程做出诊断,积极的手术治疗方法有利于提高患者的生存质量。
Objective To investigate the clinical characteristics and treatment of acute gastric perforation in order to improve the level of clinical diagnosis and treatment. Methods 25 cases of acute gastric perforation were selected. Among them, 4 cases of metastasis of cancer cells and 9 cases of severe peritoneal contamination were treated with simple perforation repair, 7 cases underwent gastric palliative resection and 5 cases underwent radical gastrectomy. Results According to histological classification, there were 3 cases of early gastric cancer, 6 cases of undifferentiated adenocarcinoma, 8 cases of poorly differentiated adenocarcinoma, 6 cases of moderately differentiated adenocarcinoma and 2 cases of signet-ring cell carcinoma. Surgical resection rate was 48.0%, and were cured. Conclusion Acute perforation of gastric cancer is usually diagnosed during the operation. Positive surgical treatment is helpful to improve the quality of life of patients.