高龄胃癌患者的临床特点及围手术期处理

Clinical characteristics and perioperative management of aged patients with gastric cancer

目的探讨高龄胃癌患者的临床表现、治疗特点及其对术后并发症的影响,以及高龄胃癌患者的围手术期处理。方法回顾性分析手术治疗的101例高龄胃癌患者的临床资料,着重分析术前合并症与术后并发症的治疗。结果大于70岁的高龄胃癌患者(高龄组)有临床表现多无特异性、病变部位及范围不同、术前合并症多等临床特点。高龄组术前合并症发生率为49.5%(50例),对照组(小于70岁的胃癌患者)为21.3%,两组差异有统计学意义(P<0.05);高龄组术后并发症发生率为18.8%,对照组为15.2%,但两组无统计学差异(P>0.05);高龄组胃癌手术切除98例(97.0%),其中根治性切除87例(86.1%)。结论高龄胃癌患者术前合并症较多,术后并发症发生率也较高。加强此类患者的围手术期处理,对减少术后并发症,提高生存率和生活质量有重要意义。

Objective To evaluate the clinical manifestations,therapeutic characteristics,postoperative complications and perioperative management of elderly patients with gastric cancer.Methods Clinical data of 101 aged paients with gastric cancer were retrospectively analyzed.The analysis mainly focused on the management of preoperative coexistent diseases and postoperative complications.Results Gastric cancer patients more than 70 years old（aged patient group） had non-specific clinical manifestations and significantly higher rate of preoperative coexistent diseases compared to the control group of gastric cancer patients who were less than 70 years of age（49.5% vs.21.3%,respectively,P0.05）.The postoperative complication rate in the elderly patients（18.8%） and younger patients（15.2%） was not significantly different（P0.05）.Among the elderly patients with gastric cancer,98 cases（97%） underwent surgical resection,including 87 cases（86.1%） who had radical resection.Conclusions The rate of preoperative coexistent diseases and postoperative complications are higher in aged patients with gastric cancer.Reinforcement of perioperative management of aged patients with gastric cancer could significantly reduce the incidence of postoperatvie complications and improve the survival rate and quality of patient′s life.