摘要
624倒原发性食管癌患者分成高龄组(≥70岁,n=43)和非高龄组(<70岁,n=581)。比较术前危险因素,高龄组患者贫血、高血压、心功能不全及肺功能不全的患病率显著高于非高龄组(P<0.01)。肝肾功能不全及糖尿病的患病率两组无差异。比较手术并发症,高龄组吻合口瘘及切口愈合不良的发生率显著高于非高龄组(P<0.05);术后器官并发症中,非高龄组心脏及肺部并发症显著高于非高龄组(P<0.01)。吻合口瘘和肺部并发症与术前危险因素及手术方式密切相关。资料分析提示,手术创伤对老年食管癌患者呼吸系统影响最大,手术适应证中强调肺功能需正常;老年食管癌患者尽量避免三切口及二切口右胸顶吻合术,应采用左胸单切口手术为妥;加强围术期呼吸道管理,防治呼吸系统并发症是决定手术成败的关键。
Totally 738 patients with primary esophageal cancer were divided into younger group (<70 years,n = 581) and elder group (≥70 years,n = 43). As for the preoperative risk factors, the incidence of anemia, hypertension, cardiac dysfunction and pulmonary dysfunction in elder group were significantly higher than those of younger group (P<0. 01). There was no difference between the incidence of liver dysfunction, renal dysfunction and diabetes in the 2 groups. As for operative complications, the incidence of anastomotic leak and poor healing of incision in elder group were much higher than those of younger group (P<0. 05). The incidence of cardiac and pulmonary complications was also much higher than those of younger group (P<0. 01). There was close relationship between anastomotic leak, pulmonary complication and preoperative risk factors and operative methods. The respiratory system of elderly patients with esophageal cancer was mostly affected by operation. Normal pulmonary function was of great importance in operative indications. Three-incisional and two-incisional approach should be avoided for the operative treatment of esophageal cancer in elderly patients. It is advisable to choose left thoracic single-incision approach, and the key for operative success is to prevent complications of respiratory system.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2003年第10期1154-1156,共3页
Academic Journal of Second Military Medical University
关键词
食管癌
外科手术
治疗
危险因素
手术方法
aged
esophageal cancer
operative indication
preoperative risk factors
operative methods
postoperative complications
