老年头颈肿瘤患者并存病的围手术期处理

The Perioperative Management of the Coexisting Diseases for the Elderly Patients with Head and Neck Neoplasms

目的:探讨老年头颈肿瘤患者并存病的围手术期处理。方法:对82例有一种或一种以上并存病的老年头颈肿瘤患者临床资料和围手术期处理进行分析讨论。结果:并存心脏病36例,高血压17例,糖尿病20例,呼吸系统疾病19例,肝功能异常8例,低蛋白血症5例,营养不良3例,其他5例。术后一过性并发症有术腔感染5例(其中3例为并存糖尿病患者),肺部感染4例,严重低血钠1例,尿潴留诱发严重心律失常1例,围手术期无死亡病例。结论:老年头颈肿瘤患者并存病以心血管疾病最多见,但糖尿病也对手术有很大的威胁。术前全面了解病情,加强并存病的围手术期处理,可大大提高手术成功率。

Objective： To explore the perioperative management of the coexisting diseases for the elderly patients with head and neck neoplasms. Method：The perioperative treatment for head and neck neoplasms with the coexisting diseases in 82 patients over 60 years old was analyzed retrospectively. Result ：The coexisting diseases included heart diseases （ 36 cases ） , hypertension （ 17 cases ）, diabetes （ 20 cases ） , respiratory diseases （ 19 cases ） , hypertension （ 17cases ） , diabetes （ 20 cases ） , respiratory diseases （ 19 cases ） , obnor- mal hepatic function （ 8 case ） , hypoproteinemia （ 5 cases ） , malnutrition （ 3cases ） , and others （ 5cases ）. Post - operative complications： wound infection （ 5cases ） , pneumonia （ 4 cases ）, severe hyponatremia （ 1 case） , and severe arrhythmia for uroschesis （ 1 cases）. No patients died in perioperation period. Conclusion： The hot diseases was commoly seen in coexisting disease for the elderly patients with head and neck neoplasms, and diabetes make greatly risk to the operation. Complete assessment of the patient＇ s general health and intensive perioperative management of the coexisting diseases can increase the success rate of operation.