老年人胃癌穿孔32例的临床分析

目的 探讨老年人胃癌穿孔的临床特点，提高其诊断与治疗水平。方法回顾性分析收治的32例老年胃癌穿孔的临床资料。结果32例中行穿孔修补术10例，胃癌姑息性切除术16例，胃癌根治术4例，未手术2例。院内死亡率分别为40．0％、12．5％、0．0％、100．0％。并发症发生率分别为80．0％、37．5％、50．0％、100．0％，出院平均生存期分别为7个月、19个月、25个月、0个月。结论准确的疾病诊断、合理的术式选择和加强围手术期的处理对降低老年胃癌穿孔死亡率、并发症发生率，改善其预后有重要意义。

Clinical analysis of 32 cases of senile perforation of gastric cancer

Objective To investigate the clinical features of gastric perforation due to gastric cancer in elderly patients and improve the diagnosis and treatment. Methods The clinical data of thirty-two senile patients with gastric cancer perforation were analyzed retrospectively. Results Of the thirty-two patients, ten underwent repair of perforation, sixteen cases underwent palliative gastrectomy, four were subjected to radical gastrectomy, two received non-operative therapy. The mortality rate in hospital was 40.0%, 12.5%, 0.0% and 100.0% respectively. The morbidity rate of complications was 80.0%, 37. 5%, 50. 0% and 100. 0% respectively. The mean survival time was 7 months, 19 months, 25 months and 0 month respectively. Conclusions In order to reduce mortality, morbidity of complications and to improve the prognosis of senile patients with gastric cancer perforation, it is important to make an accurate diagnosis, to choose the rational method of the operation and to strengthen the perioperative management.