Analysis Of 94 Cases Of Gastric Bleeding After Gastrectomy

Objective: Including 94 cases of postoperative gastrointestinal bleeding, 5702 cases of gastric cancer, operated in the Fourth Hospital of Hebei Medical University during 1996 to 2006, was selected in order to analyze the influence of postoperative bleeding, to improve the diagnosis and treatment, and to reduce the incidence of postoperative bleeding.Methods: Survey the 5702 cases which were under operation in our hospital, from the time of 1996 to the time of 2006. The racial operation cases were included and the else were under the palliative operations. The ninety-four of 5702 cases were diagnosed postoperative hemorrhage. The diagnostic standard of the postoperative hemorrhage: (1) in 24 hours or more hemoglobin decreased 3g/dL. (2) Drainage of bloody fluid from the stomach tube or abdominal drainage tube was more than 200ml, in 24 hours. Or cumulative bloody fluid were more than 600ml. (3) Vital signs were not stable, or had the performance of the pre-shock. (4) Blood pressure decreased 40mmHg or more or needed to infusion more than 2 units packed red blood cells to maintain stable vital signs. Using excel to build up a database of the 2311 cases, analyze the data with SPSS18.0 and count data withχ~2 test to explore and summarize the risk factors for postoperative bleeding of gastric cancer.Result: The incidence of postoperative hemorrhage with gastric cancer was 1.65%, one of which were died, seventy cases of which were gastrointestinal bleeding and the else were abdominal hemorrhage. Gender, age, hypertension, previous abdominal surgery, family history of cancer did not show a positive result, suggesting little effect on postoperative bleeding. It is in line with previous studies. However the preoperative hypoalbuminemia, diabetes, approach of the cardiac surgery, the use of stapler, racial operation were positive factors compared with the control group. Analyzing of the re-operation of patients ,five patients were with gastrointestinal bleeding as the main symptom and the other three cases, placed postoperative abdominal hemorrhage as the main symptoms. Four cases were thoracotomy, and other four were laparotomy .Re-operation could clear the reasons for blooding: four cases of thoracic surgery were anastomotic bleeding .In the four cases of re-operation two of them were anastometic bleeding while others were splenic injury and stump bleeding.Conclusion: Before surgery to correct hypoproteinemia to improve the general conditions of patients, and to use staplers normatively in operates, could reduce postoperative hemorrhage and the incidence of death risk.