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目的探讨晚期胃癌合并幽门梗阻的诊断和治疗。方法回顾性分析12例晚期胃癌合并幽门梗阻患者的诊断特点、手术原则和化疗方法。结果围手术期死亡2例,其中胃肠吻合术1例,胃造瘘术1例。其余胃肠吻合术者5例术后生存3~9个月;姑息性肿瘤切除术者4例,术后平均生存1.5年;胃癌根治术(联合脏器切除)者l例,生存3.5年。腹腔灌注化疗比全身静脉化疗副反应轻,效果好。结论晚期胃癌合并幽门梗阻诊断、治疗复杂。局部肿瘤减量手术辅以腹腔灌注化疗可以延长患者生存期,提高生活质量。
Objective To investigate the diagnosis and treatment of advanced gastric cancer complicated with pyloric obstruction. Methods A retrospective analysis of 12 cases of advanced gastric cancer with pyloric obstruction in patients with diagnostic features, surgical principles and chemotherapy. Results Perioperative death in 2 cases, including gastrointestinal anastomosis in 1 case, gastrostomy in 1 case. The remaining 5 cases of gastrointestinal anastomosis survived 3 to 9 months after surgery; palliative resection in 4 cases, an average of 1.5 years after surgery; radical gastrectomy (combined with organ resection) in 1 case, surviving 3.5 years. Intraperitoneal chemotherapy than intravenous chemotherapy light side effects, the effect is good. Conclusions The diagnosis of advanced gastric cancer complicated with pyloric obstruction is complicated. Local tumor reduction surgery combined with intraperitoneal chemotherapy can extend the patient’s survival and improve quality of life.