老年妇科恶性肿瘤术后并发症相关因素分析——附114例报告

Analysis on risk factors of postoperative complications in senile women with gynecological malignancies

目的:探讨65岁以上老年妇科恶性肿瘤患者术后并发症的相关因素。方法:对114例65岁以上妇科恶性肿瘤患者的临床资料进行数理分析。对术后并发症发生率与年龄、术前合并症、FIGO分期及手术方法的关系进行Logistic回归分析。结果:114例患者中,35例(31%)术后出现并发症,共63例次,其中严重并发症(包括脑梗死、下肢静脉栓塞、肺动脉栓塞、酮症酸中毒、不完全肠梗阻、手术切口裂开)12例(11%)。经Logistic回归分析,结果显示术前有合并症与术后出现并发症有关(优势比为3.89,P<0.01),而与年龄、FIGO分期、手术方式无关。对术后出现合并症的患者,均予相应的处理。除1例并发肺动脉栓塞患者(有高血压史10年)于术后第2日猝死外,其余患者均安全渡过围手术期。结论:术前有合并症的老年妇科恶性肿瘤患者易发生术后并发症。对老年妇科恶性肿瘤患者应做好充分的术前评估、积极处理术前并发症,术中严密监护并及时处理有助于降低术后并发症的发生率,使其安全渡过围手术期。

Objective： To investigate the risk factors of postoperative complications after operation for gynecological malignan- cies in senile women over 65. Methods： 114 patients over 65 treated by surgical procedures were analyzed retrospectively. The relationship between postoperative complications and age, preoperative complication, F1GO staging and surgical methods were analyzed by logistic regression analysis. Results： Among 114 patients, 35 cases （31%） had postoperative complications total 63 times. Major complications occulted in 12 eases （ 11% ） （ including cerebral infarction, deep venous thrombosis of lower limbs, pulmonary embolism, ketoaeidosis, incomplete ileus and surgical wound dehiscence）. Logistic regression analysis showed that patients with preexisting medical illnesses had a higher risk of postoperative complications （ OR = 3.89, P 〈 0.01 ）. However, the risk of postoperative compli- cations was not correlated with age, FIGO staging and surgical methods. Postoperative complications were properly treated. Only one patient died of pulmonary infarction on the second day after operation （ with a history of hypertension for ten years）. Conclusion： Senile women patients of gynecological malignancies with preexisting medical illnesses are more likely to have major complications. Adequate preoperative assessment, active treatment for preoperative complication and intensive monitoring during operation will help to reduce the rate of postoperative complications, so that patients safely get through the perioperative period.