老年直肠癌患者经腹会阴联合直肠癌切除术的危险因素分析

Risk factors of elderly patients with abdominoperineal resection for rectal carcinoma

目的分析影响老年直肠癌患者经腹会阴联合直肠癌切除术的危险因素。方法对1995年7月至2005年7月60岁以上的137例直肠癌患者行经腹会阴联合直肠癌切除术(Miles式)的资料进行回顾性分析,确定影响老年直肠癌患者Miles手术的危险因素。结果术前并有疾病、血红蛋白质低于70g/L、身体质量指数(BMI)低于18.5kg/m2、术中失血量大于或等于1000ml、手术时间6h以上是老年直肠癌患者Miles手术的危险因素,发生死亡的相对危险度分别为4.76、5.85、6.49、5.47、3.90,发生并发症的相对危险度分别为2.02、2.27、1.83、2.01、1.70。结论老年直肠癌患者行直肠癌切除时应综合考虑以上危险因素,以便提高手术的安全性。

Objective To analyze the relative risk factors of elderly patients with abdominoperineal resection for rectal carcinoma. Methods The risk factors for hospital death and postoperative complications in 137 elderly patients who had undergone abdominoperineal resection for rectal carcinoma from July 1995 to July 2005 were analyzed retrospectively. Results The risk factors included coexistent diseases, hemoglobin level less than 70 g/L, body mass index （BMI） less than 18.5 kg/m^2, intraoperative blood loss more than 1 000 ml, operating time longer than 6 h. The relative risk ratio were 4.76, 5.85, 6.49, 5.47, 3.90 respectively for hospital death, and 2.02, 2.27, 1.83, 2.01, 1.70 for postoperative complications. Conclusion The risk factors of the elderly patients with abdominoperineal resection for rectal carcinoma should be considered carefully during the perioperative period.