老年原发性肝癌手术治疗70例分析

Surgical treatment of 70 cases of elderly primary hepatic carcinoma

目的 分析老年人原发性肝癌（PHC）外科手术治疗临床疗效.方法 对我院2001年5月至2007年10月经手术切除的70 例老年（年龄≥60岁）PHC资料进行回顾性分析.结果 70例中64例术后恢复出院,6例围手术期死亡（8.6%）,术后大量腹水27例,胸腔积液21例,肺部感染19例,心功能衰竭11例,切口感染10例,大出血7例,肝功能衰竭4例.术后随访,7例半年内肝内复发并死亡,1年存活率81.4%（57/70）,3年存活率45.2%（19/42）.结论 手术仍是老年人原发性肝癌的首选治疗方法,应注重围手术期处理、手术指征及术中操作技巧.

Objective To evaluate the clinical curative effect of surgical treatment for elderly primary hepatic carcinoma （PHC）. Methods The clinical data of 70 cases of elderly patients （ age 1〉60） with PHC subject to surgical operation from May 2001 to October 2007 in our hospital were retrospectively analyzed. Results Sixty - four elderly patients with PHC were cured, and 6 died （8.6%）. Postoperative complications were as follows- 27 cases of seroperitoneum, 21 cases of pleural effusion, 19 cases of pneumonia, 11 cases of congestive heart failure, 10 cases of infection of incisional wound,7 cases of massive haemorrhage, and 4 cases of hepatic failure. Pospoperative follow - up revealed that 7 cases re- curred and died in half of year,and one - and 3 year- survival rate was 81.4% （57/70） and 45.2% （19/42） respectively. Conclusion Surgical operation was the first choice for elderly PHC. Attention should be paid to perioperative management, surgical indications, and surgical skills.