【摘要】 目的 对比左心室射血分数（LVEF）降低与LVEF正常的结直肠癌病人的术后风险及预后情况，评估LVEF降低病人进行结直肠癌手术的安全性与可行性。方法 回顾性分析2008年5月至2019年12月于广东省人民医院胃肠外科接受结直肠癌手术的41例LVEF降低（LVEF<50%）以及135例LVEF正常（LVEF≥50%）病人的临床资料。采用倾向评分匹配（PSM）方法平衡两组间的协变量，PSM后纳入LVEF降低组病人37例，LVEF正常组65例。主要观察指标为总生存率和无复发生存率，次要观察指标为围手术期资料。结果 PSM后，LVEF降低组病人和LVEF正常组病人的预估总生存率分别为40.5%和63.1%，预估无复发生存率分别为36.1%和58.7%，两组总生存率和无复发生存率差异均无统计学意义（P>0.05）。按肿瘤分期进行的亚组分析结果显示，两组临床分期为Ⅰ/Ⅱ期及Ⅲ期亚组间总生存率和无复发生存率差异均无统计学意义（P>0.05）。PSM后，两组病人造口选择比例、手术并发症发生率、心脏并发症发生率、术中出血量、住院时长、重症监护病房停留时间和住院费用等术后指标差异均无统计学意义（P>0.05）。结论 在做好术前充分评估、术中妥善管理以及术后精心护理的情况下，LVEF降低的病人也能够安全接受结直肠癌手术。个体化的术前评估以及全面的围手术期管理，对于实现良好的治疗结局至关重要。更多还原

【Abstract】 Objective To evaluate the safety and feasibility of colorectal cancer(CRC) surgery in patients with reduced left ventricular ejection fraction(LVEF) by comparing postoperative risks and long-term outcomes with those having preserved LVEF. Methods This retrospective study was conducted based on the clinical data of 41 patients with reduced LVEF and 135 patients with preserved LVEF who underwent CRC surgery at Department of Gastrointestinal Surgery, Guangdong Provincial People’s Hospital between May 2008 and December 2019. Propensity score matching(PSM) was used to balance the covariates between the groups. After PSM, 37 patients were included in the reduced LVEF group and 65 in the preserved LVEF group. The primary outcomes were overall survival and recurrence-free survival rates, and the secondary endpoints were perioperative data. Results After PSM, the estimated overall survival rates were 40.5% in the reduced LVEF group and 63.1% in the normal LVEF group, while the estimated recurrence-free survival rates were 36.1% and 58.7%, respectively. There were no statistically significant differences in overall survival rate and recurrence-free survival rate between the two groups(P>0.05). Subgroup analysis by tumor stage showed no statistically significant differences in survival rates between the two subgroups(P>0.05). After PSM, there were no statistically significant differences between the two groups in the proportion of stoma selection, surgical complications, cardiac complications, intraoperative blood loss, and postoperative indicators including hospital stay, duration of intensive care unit(ICU) stay and costs(P>0.05). Conclusion With thorough preoperative evaluation, intraoperative management, and postoperative care, CRC surgery can be safely performed in patients with reduced LVEF. Individualized preoperative assessment and comprehensive perioperative management are crucial for favorable outcomes.更多还原