135例高龄胃癌患者的外科治疗

Surgical treatment of 135 elderly patients with stomach carcinoma

目的 探讨高龄胃癌患者的临床特点及外科治疗方法。方法 回顾性分析经手术治疗的 135例 70岁以上胃癌患者的临床资料。结果 高龄患者病变分期晚 ,Ⅲ、Ⅳ期占 6 7 4 % ;术前合并症占 6 8 1% ;肿瘤切除率为 76 3% ;术后并发症占 2 9 6 % ,其中术前营养不良者并发症发生率高于营养状况良好者 ,二者相比有非常显著性意义 (P <0 0 1) ;手术死亡率为 2 2 % ;肿瘤切除者 5年存活率为 30 1% (31 10 3)。结论高龄胃癌患者术前营养状况的改善以及合并症的处理是围手术期的重要环节 ,手术切除是高龄胃癌患者的首选治疗方案 。

Objective To explore the clinical characteristics and surgical treatment methods for elderly patients with stomach carcinoma.Methods The data of surgical treatment in 135 cases of gastric carcinoma over 70-year-old from January 1989 to January 1999 in our hospital were retrospectively reviewed.Results In this series, patients with stage Ⅲ and Ⅳ accounted for 67.4%. The incidence of previous diseases before operation was 68.1%.The resection rate of the carcinoma was 76.3%. The incidence of postoperative complications was 29.6%, in which patients with preoperative malnutrition had a higher incidence of complications than those without. The mortality during operation was 2.2%. Five-year livability after excision was 30.1%.Conclusion Treating previous diseases and improving nutrient condition before operation for elderly patients are essential. Surgical resection is the first choice of treatment for such patients. The option of operation methods should follow individual principle.