胃炎、胃溃疡与早期胃癌的症状有什么区别?怎样早期发现胃癌?

金牌好医生推荐 April 5, 2022
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早期的胃癌和胃炎、胃溃疡不容易区分。在美国发现胃癌大部分都已经是中期晚期了,早期胃癌在美国不多见。为什么不多见呢?因为胃癌早期没什么症状,病人只是觉得肚子不太舒服。胃溃疡反而症状更明显,病人觉得胃很疼。很多胃溃疡病人典型的描述是:吃饭的时候胃不痛,吃过饭后1~2个小时开始胃痛。比较严重的胃溃疡还会出现黑便。黑便不是普通的大便颜色变深,而是像马路上的柏油一样黑,同时伴有一种特殊的腥臭味,有点像臭鱼的味道,是比较容易辨别的。这就是上消化道出血胃溃疡的典型症状。 胃癌早期还不一定有以上的症状,所以鉴定早期胃癌比较难。在现在的医疗条件下,做胃镜检查是非常快速、比较舒适,没什么痛苦,做起来也很安全的一种鉴定胃癌的方式。早期胃癌治愈率相当高。一期的胃癌5年存活率是95%,三期的胃癌5年存活率骤降到65%。 如何早期发现胃癌?传统的做法还是要定期做胃镜。尤其是有家族病史的高危人群,要定期找医生做胃镜检查。 胃癌高风险人群有哪些? 直系亲属——父母、兄弟姐妹中,有罹患肿瘤的(不一定是胃癌,可能是肠癌、乳腺癌、子宫癌等),说明基因里有问题,对消化道同样是有影响的。 以前有胃溃疡史的病人,长期抽烟喝酒的人。 从东南亚地区来的都要小心,因为这里是胃癌高发地带。美国本土是胃癌低风险地区,尤其是美国白人,罹患胃癌的很少。华人移民虽然到了美国,仍属于胃癌高风险人群。 以前做过胃大部切除的,不管什么原因,都成为胃癌高风险人群。20年前,治疗胃溃疡没有什么特效药,治疗长期不愈合的胃溃疡,有些出现胃出血、胃穿孔,多采用手术切除溃疡面的方法进行治疗。胃大部切除后,剩下的胃叫残胃,有残胃的人都是胃癌高风险。这些人做完胃切除手术十年后,应该每年都来做胃镜检查。 以前诊断出患有萎缩性胃炎、肠上皮化生的患者,也是胃癌高风险人群; 胆囊切除的病人,因为胆囊切除后,胆汁会源源不断的流出来,有一部分胆汁会返流回胃里,对胃产生一些刺激,也有一定的风险发展为胃癌; 以前得过胃癌的人。 以上胃癌高风险人群,都需要定期找医生做检查,抓住最佳治疗时机。

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