118例胃癌手术治疗体会.docVIP

118例胃癌手术治疗体会【摘要】 目的 探讨胃癌的临床特点及治疗法。方法 对手术病理证实的118例胃癌患者的临床资料进行回顾性分析。手术方式采用全胃切除Roux?en?Y加袋术(RYP)。118例患者中临床表现为上腹部疼痛，嗳气及腹胀，占74.55％；胃镜检查确诊或疑诊为胃癌。占94.07％；癌灶位于胃窦部，占48.20％；早期胃癌占22.88％，行胃癌根治本者占88.13％。结果 全组无手术死亡病例。吻合口瘘3例，反流性食管炎4倒，切口裂开2例，左侧胸腔积液2例。大部分患者自我感觉良好，饮食接近正常。结论 胃钡餐造影和胃镜检查是诊断胃癌的主要手段；治疗仍以手术为主，而术前详细检查查、充分准备，术中细致操作、充分引流，术后加强护理是手术成功的关键。? 【关键词】 胃癌；手术治疗 ?? Expreience of surgical treatment for gastric cancer in 118 patients The Special Hospital of Zhumadian City of Henan Province，Henan 463000, China ? 【Abstract】 Objective To investigate the clinical characteristics of gastric cancer and treatment.Methods The surgical pathology confirmed 118 cases of clinical data of patients with gastric cancer were retrospectively analyzed. Roux?en?Y was used in the operation.118 cases of patients all present the clinical manifestafions of abdominal pain and abdominal distension on accounting for 74.55％，gastroscopy confirmed or suspected diagnosis of gastric cancer accounted for 94.07％，located in gastric antrum cancer accounted for 48.20％。accounting for 22.88％of early gastrie cancer，the radical resection of gastric cancer accounted for 88.13％.Results There were no patients died after treatment.3 cases of them with anastomotic leakage，reflux esophagifis in 4 cases，wound dehiscence in 2 case.The left pleural effusion in 2 case.Most patients feel good，near normal appetite.Conclusion Stomach barium meal and gastroscopy are the main means of diagnosis of gastric cancer，treatment is still surgery.And detailed examination of pre?operafive，well?prepared，detailed operation during full drainage postoperative care is surgery to strengthen the key to succeess.? 【Key words】 Gastric cancer； Surgical treatment 作者单位：463000河南省驻马店市中心医院普外一科 胃癌是一种常见的恶性肿瘤，目前来看，在世界上胃癌可以称得上是一种高发性的恶性肿瘤之一，近年来，全球胃癌发病率逐渐增加，因此对胃癌有关治疗的方面进行研究与分析就显得极为重要。目前来说，治疗胃癌的主要方法仍旧以外科手术治疗为主，因此全胃切除等较大型的手术开始频繁地被运用，从手术治疗效果来看，多数胃癌患者都可以得到比较不错的治疗效果??［1］?。我们2003年1月至2011年5月采用胃癌全胃切除Roux?en?Y加袋术(RYP)治疗胃癌患者118例，效果满意，现报告如下。? 1