老年胃癌患者全胃切除的危险因素分析

Risk factors of elderly patients with total gastrectomy for gastric cancer

目的分析影响老年胃癌患者全胃切除的危险因素。方法对胃癌数据库中1994年8月至2004年8月60岁以上的131例胃癌患者行全胃切除的资料进行回顾性分析,确定影响老年胃癌患者全胃切除的危险因素。结果术前有并存疾病、血红蛋白低于80g/L、白蛋白低于35g/L、体重指数(BMI)低于18.5kg/m2、术中失血量大于或等于1000ml、手术时间5h以上和联合脏器切除(脾/胰体尾切除)是老年胃癌患者全胃切除的危险因素,发生死亡的相对危险度分别为1.57、1.74、2.97、4.23、2.21、2.28和3.80,发生并发症的相对危险度分别为1.50、1.90、2.38、2.12、2.45、1.66和3.41。结论老年胃癌患者行全胃切除时应综合考虑上述危险因素,以提高手术的安全性。

Objective To analyze the relative risk factors of elderly patients with total gastrecomy for gastric cancer. Methods The risk factors for hospital death and postoperative complications in 131 elderly patients undergoing total gastrectomy for gastric cancer from Aug. 1994 to Aug. 2004 were analyzed retrospectively. Results The risk factors for hospital death and postoperative complications included coexistent diseases, hemoglobin level less than 80 g/L, albumin level less than 35 g/L, hedy mass index （BMI） less than 18.5 kg/m^2, intraoperative blood loss more than 1000 ml, operating time longer than 5 h, combined resection of the spleen or pancreas. The relative risks were 1.57, 1.74, 2.97, 4. 23, 2.21,2.28, 3.80 respectively for hospital death, and 1.50, 1.90, 2.38, 2. 12, 2.45, 1.66, 3.41 for postoperative complications. Conclusion The risk factors of the elderly patients with total gastrectomy for gastric cancer should be considered carefully during the perioperative period. It can increase the security of the procedure to control these risk factors.