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残胃癌的早期诊治22例分析 |
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施松 孔群
［摘要］目的 探讨残胃癌的早期诊断方法和手术处理方式。方法 总结22例临床资料，对比胃镜和钡餐对早期残胃癌的诊断价值，针对术中探查及采用的不同术式，观察其预后。结果 胃镜对早期残胃癌的确诊率达90%，而钡餐甚低，残胃联合脏器切除的患者预后较好。结论 胃术后5年开始胃镜定期普查是残胃癌早期获诊的关键，残胃联合脏器切除及广泛的淋巴结廓清应为首选术式。
［关键词］残胃癌；诊断；治疗
［分类号］A735.2 ［文献标识码］A
［文章编号］1005-6483(2000)02-0096-02
Analysis for early diagnosis and therapy on remaining stomach camer on 22 cases
SHE Song,KONG Qun.
（Department of Oncology,Yejishan Hospital,Wannan Medical College，Wuhu 241001，China）
［Abstract］Objective This sutdy is to discuss the method of early diagnosis of remaining stomach cancer and the treatment of operation.Methods Clinical date of 22 cases were collected.The diagnostic values of gastroscope and barium meal to early remaining stomach cancer were contrasted.Prognosis was observed according to the examinations made during operation and the way of operation available adopted.Results The rate of definite diagnosis of gastrosiope to early remaining stomach cancer was 90% while that of barium meal to it was almost zero.The prognosis was good for patients whose other implicated organs were together resected.Conclusion Perildical examinations by gastroscope began five years after the operation of stomach cancer was done.It was crucial to the early diagnosis of remaining stomack cancer.The immediate selection of the way of operation should be the resection of the remaining stomach cancer and other implicated organs and extensive regional lymphadenectomy.
［Key words］Remaining stomach cancer；Diagnosis;Therapy
残胃癌一般指胃十二指肠非癌瘤性疾病行胃大部切除术后5年以上发生的胃癌，随着诊断技术的提高及对残胃这种特殊的癌前状态的认识加深，残胃癌的发生逐年增多，本文收集我院1978～1997年19年间收治的残胃癌22例，对其发病情况、早期诊断及合理的手术方式等问题进行了探讨。
临床资料
一般资料：本组22例(包括外院转入2例)，其中男性14例，女性8例，年龄35～72岁，平均51岁。
初次手术病因及术式：胃溃疡15例，十二指肠溃疡4例，复合性溃疡1例，萎缩性胃炎2例。毕Ⅰ式5例，毕Ⅱ式17例。
首次手术距癌发现时间：5～9年5例，10～20年12例，＞20年5例，最长1例为28年。
临床症状：餐后腹胀5例，上腹痛5例，呕血/黑便1例，进食梗噎感2例，呕吐3例，贫血/消瘦3例，无症状3例。
床前胃镜检查：病灶位于吻合口[1] [2] 下一页
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