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目的总结胃癌合并急性幽门梗阻和出血的急诊手术经验。方法回顾我院2000年10月至2005年10月年收治的胃癌合并急性幽门梗阻和大出血的病人资料,结合有关文献,探讨胃癌病人的急诊手术时机及诊治方法。结果合并急性幽门梗阻者经胃肠减压、洗胃、补液、抗感染、纠正水电解质紊乱和酸碱平衡失调、静脉营养支持等治疗1~2周后行剖腹探查术,手术成功率100%。合并出血者经输血、止血、扩容、抗休克等治疗后行剖腹探查术,手术成功率100%。结论从诊断及治疗效果来讲,剖腹探查术仍是胃癌并发急症时的重要诊治手段。对于胃癌的防治,更关键是早期发现、早期诊断和早期治疗。
Objective To summarize the emergency operation experience of gastric cancer complicated with acute pyloric obstruction and hemorrhage. Methods The data of patients with gastric cancer complicated with acute pyloric obstruction and hemorrhage admitted to our hospital from October 2000 to October 2005 were retrospectively analyzed. The related literatures were explored to discuss the emergency operation timing and diagnosis and treatment of gastric cancer patients. Results Acute pyloric obstruction by gastrointestinal decompression, gastric lavage, rehydration, anti-infective, correct water and electrolyte imbalance and acid-base balance disorders, intravenous nutritional support for 1 to 2 weeks after laparotomy exploration, the success rate of 100%. Bleeding by transfusion, bleeding, expansion, anti-shock and other laparotomy after surgery, the success rate of 100%. Conclusion From the diagnosis and treatment effect, laparotomy is still an important diagnosis and treatment of gastric cancer in emergencies. For the prevention and treatment of gastric cancer, more critical is the early detection, early diagnosis and early treatment.