The case expert of gastric carcinoma analyzes _'s treatment

The case expert of gastric carcinoma analyzes _'s treatment
Patient: Silk gauze * * ,Male, 41 years old, the native in Shantou of Guangdong.
Basic medical history: Because " the repeated upper abdomen has been uncomfortable for one year, relieve oneself in January black " Admitted to hospital.
Go to a doctor in the hospital: Zhongshan University attaches to the pancreas specialized department of first hospital intestines and stomach
The patient began to have no obvious inducement to present the uncomfortable sense of upper abdomen 1 year ago, took glutted after the meal, secret anguish as the core, leave degree to be light to pay special attention to for the first time, the intersection of clothes and " the the intersection of stomach and medicine " since break out, And then took a favorable turn, began glutted sense and secret anguish of upper abdomen to aggravate half a year ago, influenced work and sleep, obvious after the meal, influence the appetite, the weight slightly drops, draft " chronic gastritis, gastric ulcer " in the other institute Inhibit the gastric acid, protect the mucous membrane of stomach and stop the pain etc. to treat, symptom is relieved to some extent, but the weight dropped gradually, began to arrange black stool one month ago, began not to pay attention to, rare when and then develop in order to arrange the pitch kinding, family find at the same time their complexions are relatively greenish yellow, patient feels tired, weak, absent minded too, with turning black at the moment sometimes, go to the large local hospital to check the gastroscope to diagnose as tentatively " Stomach sinus cancer " ,In order to further diagnose clearly that comes to Zhongshan University to attach to the pancreas specialized department of first hospital intestines and stomach to go to a doctor.
The patient is in obviously becoming thin state while coming to Zhongshan University to attach to the pancreas specialized department of first hospital intestines and stomach, the weight in half a year of private prosecution has dropped by 10 kilograms. Mucous membrane pale, intermediate anaemia of the skin behaves. It is swelling that the simple table lymph node is not reached. The belly is soft, without tenderness, have not touched the piece of the bag. The rectum is checked and has not found that obviously unusual. Zhongshan University attaches to the pancreas specialized department gastrocopy of first hospital intestines and stomach to brief on " The stomach sinus one is low to differentiate gland cancer " ,Walk and draw blood and test briefing on after being admitted to hospital " The hemochrome 92 g/L " ,Tumour mark thing normal, chest slice check, find lung shift, the intersection of belly and CT check, find " the intersection of stomach and the intersection of sinus and the intersection of and coat of the stomach increase thick, have not seen the obvious histoorgan around infringe and behave, have not found the liver is shifted " ,Think the patient has operation indication after the complete case is discussed. Patient gastric carcinoma effect a radical cure skill, excise 3/5 of the stomaches and clean the lymphoid tissue around on walk will it be August 23 2006, operation smooth, rectum pull out, offer stomach tube arrange angry, postoperative the third day, from the intersection of liquid and diet Carry out the transition to half sulphur diet (porridge, powder, surface,etc.) gradually ,Until postoperative 6 day recover, leave hospital, return to institute and remove the suture of wound 2 days later. Patient pathology check, find " stomach low to split up gland cancer, cancerous swelling lies in the stomach sinus portion behind the operation, infringe under the serous coat, have 7 lymph nodes and have metastasis of cancer to dissect 32 lymph nodes, pathology is T3N1M0 by stages, and IIIA stage " ,Postoperative third circle patient begins to accept chemotherapy, once, carry on chemotherapy 8 times together every three weeks, except vomits during chemotherapy and brothers' skin turns black without having obvious side reaction. Operation future trouble person law reexamine gastroscope, the intersection of chest and slice, CT, draw blood,etc., already half 2 years after the operation now, the life work is totally normal, have not found tumour recurs.
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