老年食管癌患者的围术期处理

Perioperative Treatment of Elderly Esophageal Cancer

目的探讨老年食管癌围术期的处理措施。方法回顾分析济源市人民医院2004年—2008年42例患者的临床资料。结果本组42例病人出现双下肺部感染11例,其中出现肺不张并呼吸衰竭2例,痰多引起窒息2例,无吻合口瘘病例,1例肝硬化失代偿期术后出现双侧胸腔积液、腹水。经对症、支持治疗,本组病人均痊愈出院。结论随着手术技术的不断提高,正确选择手术适应证,术中、术后防止并发症的出现,老年食管癌患者手术治疗的成功率较高。只要病例选择适当,术前准备充分,麻醉过程平稳,术中操作精细,术后监护周全,患者可完全耐受手术治疗。

Objective To evaluate the perioperative elderly esophageal cancer treatment measures. Methods Retrospective analysis of our hospital in 2004 and 2008 clinical data of 42 patients. Results 42 patients under double -lung infection in 11 cases, of which there atelectasis and respiratory failure in 2 cases, sputum caused by suffocation in 2 cases, no cases of anastomotic leakage, 1 case with decompensated cirrhosis after there bilateral pleural effusion, ascites. After symptomatic, supportive care, this group of patients were discharged. Conclusion With the continuous improvement of surgical technique, correct choice of surgical indication, intraoperative and postoperative complications to prevent the emergence of surgical treatment of elderly patients with esophageal carcinoma a higher success rate. As long as proper patient selection, preoperative preparations, stable during anesthesia, surgery to operate sophisticated, comprehensive postoperative care, the patient may be completely tolerated surgery.