老年人肺癌切除术的并发症及死亡率的影响因素

Factors affecting morbidity and mortality after pulmonary resection of elderly lung cancer patients

目的分析影响老年人肺癌切除术并发症及死亡率的因素。方法回顾总结近20年120例70岁以上肺癌手术病人的病情资料,分析影响手术并发症及死亡率的因素。结果充血性心力衰竭及有心肌梗死病史的病人,死亡率明显升高;男性病人、吸烟、FEV1<40%的病人有更高的术后并发症发病率,肺叶或双叶切除者比楔形切除者高,近7年的手术比以前的手术并发症低。而糖尿病、高血压、及咳嗽、体重下降、胸痛、憋气等临床症状对手术死亡率和并发症发生率无统计学影响。结论老年人的肺癌手术切除是可行的,老龄肺癌病人的手术治疗一方面要持积极的态度,另一方面要加强围术期的管理,尽量减少并发症的发生。

Objective： To analyze predictors affecting morbidity and mortality after pulmonary resection of elderly patients. Methods： The medical records of elderly patients who had pulmonary resection for lung cancer from 1986 to 2006 were reviewed. Results： Congestive heart failure and prior myocardial infarction,male, smoke, FEV1, extent of puhnonary resection, operation in recent 7 years were factors affecting complications. But diabetes, hypertension, cough, weight loss, chest pain, dyspnea were not associated with increased morbidity. Conclusion： Puhnonary resection for lung cancer of eld-erly patients is feasible. We should take an active attitude to surgical treatment and enhance the peri-operation management so as to reduce morbidity.