摘要
目的：探讨共患心血管疾病的65岁以上老年结直肠癌患者术后并发症的发生情况。方法2013年1月至2014年12月期间，在北京医院接受手术治疗而年龄≥65岁的结直肠癌患者共计381例，均为经病理明确诊断为结直肠腺癌并首次手术者。根据是否共患心血管疾病分为共患心血管疾病组（258例）和无心血管疾病组（123例），回顾性分析两组患者的病例资料，比较两组患者术后并发症发生情况。结果两组患者术后并发症发生率[27．9％（72／258）比29．3％（36／123）]比较，差异无统计学意义（P ＞0．05）；按照外科手术后并发症Clavien-Dindo分级，两组并发症发生的级别比较，差异也无统计学意义（P ＞0．05）。共患心血管疾病组术后心血管并发症发生率显著高于无心血管疾病组[7．4％（19／258）比0．8％（1／123），χ2＝6．678，P ＝0．010]；而两组术后肺部并发症和腹部并发症发生率差异均无统计学意义（均P＞0．05）；其他并发症（下肢深静脉血栓、泌尿系感染和肾脏并发症等）发生率共患心血管疾病组低于无心血管疾病组[2．7％（7／258）比8．1％（10／123），χ2＝5．733，P ＝0．017]。不同心血管疾病类型以及不同级别的心血管风险指数和ASA评级，均与患者术后并发症的发生率无关（均P＞0．05）。结论共患心血管疾病的65岁以上结直肠癌患者手术治疗是安全的，但应对这类患者加强在围手术期心血管系统的监控，及时采取必要的应对措施。
Objective To investigate the risk of postoperative complications in elderly colorectal cancer patients over 65 years with comorbid cardiovascular diseases. Methods A total of 381 elderly colorectal cancer patients over 65 years were pathologically diagnosed as colorectal adenocarcinoma and underwent the first surgery in Beijing Hospital during January 2013 and December 2014. Patients were divided into comorbid cardiovascular disease group （258 cases） and non-cardiovascular disease group （123 cases） according to the existence of comorbid cardiovascular disease. The morbidity of postoperative complication was compared between two groups. Results There was no significant difference in the morbidity of postoperative complication between two groups [27.9%（72/258） vs. 29.3% （36/123）, P 〉 0.05]. According to the Clavien-Dindo classification of postoperative complications, the morbidities of complication at all levels between two groups were not significantly different （all P 〉 0.05）. But in terms of cardiovascular complications, the morbidity of comorbid cardiovascular disease group was significantly higher than that of non-cardiovascular disease group [7.4%（19/258） vs. 0.8%（1/123）, χ2 = 6.678, P = 0.010], while no significant differences in pulmonary and abdominal complications were found between two groups （all P 〉 0.05）. The morbidities of other complications （deep vein thrombosis, urinary tract infection and renal complications, etc.） of＆nbsp;comorbid cardiovascular disease group were lower than those in non-cardiovascular disease group [2.7%（7/258） vs. 8.1%（10/123）, χ2 = 5.733, P = 0.017]. Different types of cardiovascular diseases, different levels of cardiac risk index and American Society of Anesthesiologists （ASA） rating were not significantly related to the patient′s occurrence of postoperative complications （all P 〉 0.05）. Conclusions Surgery treatment for elderly colorectal cancer patients over 65 years with comorbid cardiovascular diseases is safe. However, strict cardiovascular monitoring should be performed and necessary measures should be carried out in time.
出处
《中华胃肠外科杂志》
CAS
CSCD
北大核心
2016年第9期1035-1039,共5页
Chinese Journal of Gastrointestinal Surgery
关键词
老年人
结直肠肿瘤
心血管疾病
外科手术
并发症
Elderly
Colorectal neoplasms
Cardiovascular disease
Surgery
Complications
