【摘要】 [目的]分析影响老年直肠癌术后存活时间的高危因素.[方法]回顾性分析2006年4月至2013年10月间经手术治疗的83例老年直肠癌患者的临床资料,对影响预后的因素进行单因素和多因素分析.[结果]83例均行手术治疗,建立了影响直肠癌术后生存的危险状态函数.单因素分析结果显示,TNM分期、分化程度、组织学分型、营养不良、输血、神经侵犯、原有疾病是影响术后恢复的影响因素.多因素分析结果显示,TNM分期、分化程度、营养不良、原有疾病是影响术后生存期的独立危险因素.[结论]TME手术有助于提高远期存活率,扩大淋巴结清扫对远期生存率无意义,正确合理的围手术期处理是提高病人存活率的关键.更多还原

【Abstract】 OBJECTIVE To analyze the factors influencing survival after total mesorectal resection in geriatric patients.METHODSGeneral information,surgical records and outcome data of 83 elderly patients with rectal cancer between April,2006 and October,2013 in SUTCM Affiliated Hospital were analyzed retrospectively.Univariate and multivariate survival analysis were conducted.RESULTSAll 89 cases were surgically treated.We established mathematic function to evaluate postoperative survival risk state after total mesorectal resection.Univariant analysis TNM staging,histological grade,histological type,blood transfusion,neurological invasion and pre-existing condition showed strong association with worse post-operative recovery outcome.Multivariate Cox regression analysis showed the size of tumor,lymph node metastasis,operation pattern,histologic differentiation are independent prognostic factors influencing survival.CONCLUSION Multivariate Cox regression survival analysis showed TME operation and extended lymph node en-bloc resection helps to improve the long-time survival rate,correct and rational peri-operative management is the key to improve the patients survival rate.更多还原