80岁以上老年人外科疾病的围手术期处理

Perioperative management of surgical disease in the elderly aged 80 and over

目的探讨≥80岁患者外科疾病手术治疗的可行性。方法对普外科收治的≥80岁外科手术治疗病人171例进行疾病种类、合并症、治疗方式和治疗效果的分析。结果79.5%(136/171)的病人存在不同类型的合并症;手术并发症发生率40.4%(69/171),共69例,123例次①感染82例次(肺部感染33例次,泌尿系统感染15例次,切口感染16例次,其他18例次),其中真菌感染15例;②器官功能不全29例次(急性心力衰竭12例次,急性肾功能衰竭8例次,其他9例次);③其他并发症12例次。手术死亡9例,病死率5.3%(9/171)。结论高龄不是外科疾病的手术禁忌,做好围手术期的处理及合理选择手术方式是治疗成功的关键。

Objective To investigate the feasibility of the operation treatment of surgical disease in the elderly aged 80 and over. Methods 171 elderly patients（over 80 years） who underwent operation were studied. The types of disease, concomitant disease, management and outcome were discussed. Results Of the patients,79. 5% （ 136/171 ） had different kinds of concomitant diseases. The incidence of surgical operation complication was 40. 4% （69/171）. The surgical complications occured in 69 patients for 123 times： ① 82 times of infection （33 times of lung infection, 15 times of urinary infection, 16 times of incision infection, 18 times of other）, among them the fungal infection occurred in 15 cases;② 29 times of Organ dysfunction （ 12 times of acute heart failure,8 times of acute renal failure, 9 times of other） ; ③ 12 times of the other complications. Nine patients died in the operation with a mortality of 5.3% （9/171）. Conclusions Advanced age is not an operative contraindication for elderly patients. Perfect perioperative management and reasonable choice of surgical operation method are the key to the successful cures.