【摘要】 目的探讨合并心肺疾病的老年胃癌患者的围术期处理方法。方法回顾性分析2013年1月至2016年5月间我院收治的90例合并有心肺疾病的老年胃癌患者的临床资料,对围术期处理方法进行总结;另选取60例同期术前无合并心肺疾病的患者作为对照组,比较两组并发症发生率和围术期死亡情况。结果所有患者均顺利完成手术,无术中死亡病例。90例患者术后发生并发症22例,发生率为24.4%,其中肺部感染8例,应激性溃疡5例,反流性食管炎4例,功能性排空障碍2例,急性胰腺炎2例,吻合口瘘1例,发生率明显高于同期无合并心肺疾病患者并发症发生率(8.3%),差异有统计学意义(P<0.05)。合并心肺疾病患者中3例围术期死亡,死因分别为心肺功能衰竭2例和急性心肌梗死1例,术前无合并心肺疾病患者无术后死亡病例。结论合并有心肺疾病的老年胃癌患者手术风险明显增加,加强围术期处理是提高手术安全性、降低围术期并发症的发生率和死亡率的关键因素。更多还原

【Abstract】 Objective To observe the perioperative measures of 90 aged gastric cancer combined with cardiopulmonary disease patients.Methods A total of 90 clinical data of aged gastric cancer combined with cardiopulmonary disease patients in our hospital from January 2013 to May 2016 were selected and analyzed retrospectively.The perioperative measures were summarized.60 cases aged gastric cancer not combined with cardiopulmonary disease patients were selected as control group.The complication rate and perioperative death condition were compared.Results All patients were successfully operated and there was no intraoperative death.Postoperative complications occurred in 22 patients,the rate was 24.4%.The complications contained 8cases of lung infection,5stress ulcer,4reflux esophagitis,2emptying dysfunction,2acute pancreatitis and 1case of anastomotic fistula.The rate was significantly higher than patients without cardiopulmonary diseases(8.3%).Three combination patients died during perioperative,of which were 2cases of cardiopulmonary function failure and 1case of acute myocardial infarction.No death was in patients without cardiopulmonary diseases.Conclusion The surgical risk is higher for aged gastric cancer combined with cardiopulmonary diseases patients.Strengthening perioperative management is critical factor to improve the safety of the operation and reduce the complication morbidity and mortality.更多还原