【摘要】 目的在分析60岁以上老年人肺癌手术适应证、并发症及围手术期处理,并对其外科治疗的方法、结果和特殊性进行探讨。方法全组77例,年龄60～78岁,平均64岁;Ⅱa期23例,Ⅱb期29例,Ⅲa期18例,Ⅲb期7例,行全肺切除4例,肺叶切除67例,肺段切除2例。其中6例行支气管袖状切除成形。2例在胸腔镜辅助小切口下完成肺段或肺楔形切除术。结果全组无手术死亡,手术切除率为94.8%,术后并发症发生率为24.6%。随访率为87%,1、3、5年生存率分别为86.5%、47.7%、31.3%。结论在严格选择手术适应证的前提下,结合术中肺功能保护及周密的围术期处理,老年患者术后可获得相对良好的远期预后,应采取积极的手术治疗。更多还原

【Abstract】 Objective The prevalence of lung cancer in the elder increases gradually recently,and lung cancer has become the main cause of cancer-related death.The aim of this study is to analyse the operative in dication,complication,perioperative management and surgical measures,results and specificity for lung cancer in the 60 elderly patients.Methods 77 elderly patients with lung cancer,aged from 60 to 78 years old with mean age of 64 were analysed.Of the 77 cases,23 in stage Ⅱa,29 in stage Ⅱb,18 in stage Ⅲa,7 in stage Ⅲb.Surgical procedures included pneumonectomy for 4 patients,lobectomy for 67 patients,segmentectomy and wedge resection for 2 patients.sleeve lobectomy for 6 patients.Video-assisted thoracic surgery was performed in 2 cases for segmentectomy and wedge excision.Results There was no operative death.The resection rate was 94.8%,and postoperative complication rate was 24.6%.The follow-up rate was 87%.The 1,3,5 year survival rate was 86.5%,47.7%,31.3% respectively.Conclusion Operative indications,active protection of pulmonary function and careful perioperative management are necessary for obtaining good therapeutic results and long-term prognosis in elderly patients.更多还原