老年高位胃癌的临床特点和外科护理

Clinical characteristics and surgical nursing for elderly patients with high location stomach carcinoma

目的：探讨老年胃癌患者的临床特点及外科护理方法。方法：回顾性分析2001年1月～2008年12月的136例65岁以上高位胃癌患者的临床资料及护理情况。结果：老年高位胃癌患者发病隐匿且常伴有出血、梗阻及贫血;绝大多数合并有其他疾病,术前合并症占53%。主要采用经腹近端胃切除术,根治性切除率为85%,姑息性切除率为9%,术后并发症为31%,手术死亡率为3%。对围手术期的心理问题采用相应的护理对策,心理问题得到了缓解。结论：对老年高位胃癌患者,应争取早期诊断,及时治疗。经术前充分准备,术后积极处理,老年人多能耐受手术。而适当的手术时机及手术及护理方法的选择,是提高根治性切除,减少并发症,降低病死率的关键。

Objective To explore the clinical characteristics and surgical nursing methods for elderly patients with high location stomach carcinoma. Method The clinical data and nursing station were analysed retrospectively in 136 patients with high location stomach carcinoma aged over 65 years during Jan 2001 to Dec 2008. Results The stomach carcinoma in elderly patients had an occult occurrence and frequently accompanied by bleeding, obstruction and anemial. Most of the old patients had other diseases. The incidence of postoperative complications was 53%. Transabdominal proximal gastrectomy was the mainly applied. Radical resection rate was 85 %, palliative resection rate was 9%, post operation complication rate was 31% , mortality rate was 3%. The perioperative nursing aiming at psychological problems received excellent results. Conclusion Early diagnosis and treatment is important in high location stomach carcinoma of the elderly. The old patients can tolerate operation by optimal preparation and careful treatment. Timely operation and choice of operative procedure are important in reducing complication and mortality rates, also in improving the efficacy of curative resection.