老年原发性肝癌肝切除术疗效分析

The effect of hepatic resection for the elderly patients with primary liver cancer

目的探讨老年性原发性肝癌患者肝切除术的治疗效果和围手术期特点。方法对我院1990年1月至2006年12月年龄≥60岁并行肝切除的89例原发性肝癌患者的临床资料进行回顾性分析；并随机抽取同期年龄〈60岁的90例患者作对照。结果与对照组患者相比，老年组肝癌患者HBV感染率、AFP阳性率低，术前伴发病较多，肿瘤包膜阳性率及术后1年总生存率较高；而两组患者的性别构成、临床症状、术前肝肾功能、肝硬化、卫星病灶、癌栓、术前肿瘤破裂、术中失血量、根治性切除率、术后并发症发生率、术后无瘤生存率等方面差异无统计学意义。结论肝切除术治疗老年原发性肝癌患者是安全的，对无术前伴发病或术前已有效控制伴发病的老年原发性肝癌患者，肝切除术是治疗的首选方案。

Objective To evaluate the curative effect of hepatectomy for elderly patients with primary liver cancer （PLC）. Methods The clinical data of 89 elderly patients （ ≥ 60 years of age） suf- fered from PLC and hepatectomy from Jan 1990 to Dee 2006 and 90 patients（ 〈 60 years of age） as control group in the same period of our department of Taihe hospital were analyzed retrospectively. Results The elderly PLC patients had lower HBsAg- positive rate, AFP -positive rate, more complications before operation, higher rate of tumor capsule formation and higher 1 - year post - operation survival rate than the control group; while there were no statistically significant differences between the two groups in other factors （ including sex ratio, positive symptom, liver function, renal function, accompanying cirrhosis, satellite lesions,tumor rupture,blood loss,resection rate, post operation complication and diseasefree survival rate）. Conclusion Hepatic resection was effective for elderly patients with PLC. For the elderly patients without complications or with controlled complications, hepatic resection was a safe and effective treatment.