【摘要】 目的探讨75岁以上老年胃癌患者术前合并疾病、临床病理情况以及术后并发症发生情况及其危险因素。方法回顾性分析2009年1月至2009年12月间我院施行胃癌根治手术的337例患者,其中年龄≥75岁的患者40例,占11.87%,其余小于75岁的患者297例作为对照组,分析比较两组患者术前合并症等临床病理资料及术后并发症情况。结果老年组患者术前合并心脏、肺部疾病及低蛋白血症的比例分别为37.5%、12.5%、30.0%,显著高于非老年组的15.5%、5.8%、12.8%(P<0.05)。老年组患者分化型胃癌、ASAⅢ级、UICC分期Ⅲ+Ⅳ期患者所占比例显著高于非老年组(P<0.05)。术后并发肺部感染37例、心率失常6例。老年组术后肺部感染、心率失常发生率分别为22.5%(9/40)、7.5%(3/40),显著高于非老年组的9.4%(28/297)、1.0%(3/297),差异均有统计学意义(P<0.05)。术前合并心肺疾病患者术后心肺并发症发生率显著高于术前未合并心肺疾病患者(P<0.05)。结论老年胃癌患者肿瘤分化较好、临床分期较早,但合并基础疾病较多,易导致术后并发心肺并发症,应在围手术期积极处理,减少并发症,尽量根治肿瘤,延长患者生存时间。更多还原

【Abstract】 Objective To investigate pre-operative coexistent diseases,clinical pathology,and analyze post-operative complications and their causes in elderly patients over 75 years old with gastric cancer.Methods Clinical data of 337 gastric cancer patients undergoing radical resection in our hospital from January 2009 to December 2009 were analyzed retrospectively.There were 40 patients over 75 years old(elderly group) and 297 patients with an age no more than 75 years(non-elderly group).The pre-operative coexistent diseases and post-operative complications were compared between elderly group and non-elderly group.Results The proportions of the patients with pre-operative cardiac,pulmonary diseases and hypoproteinemia were 37.5%,12.5% and 30.0%,respectively in elderly group,significantly higher than 15.5%,5.8%,12.8% in non-elderly group(all P<0.05).The proportions of the patients with differentiated tumor,ASA Ⅲ,TNM Ⅲ+Ⅳ staged tumor were significantly higher than those in non-elderly group(all P<0.05).Post-operative pulmonary infection and arrhythmia occurred respectively in 37 and 6 cases.The morbidity rates of pulmonary infection and arrhythmia were 22.5% and 7.5% respectively in elderly group,significantly higher than 9.43% and 1.0% respectively in non-elderly group(P<0.05).The postoperative cardiopulmonary complications were correlated with pre-operative coexistent cardiopulmonary diseases.Conclusions Elderly patients with gastric cancer often have differentiated and early TNM staged tumors,and more preoperative comorbidities which will increase the risk of post-operative cardiopulmonary complications following radical gastrectomy.Radical gastrectomy should be performed with positive peri-operative managements for elderly patients to improve their prognosis.更多还原