80岁以上高龄腹部肿瘤患者的围手术期处理

Perioperative management of over 80 years elder patients with abdominal tumor

目的探讨80岁以上高龄腹部肿瘤患者的围手术期处理。方法回顾性分析2004年1月至2009年12月收治的41例80岁以上腹部肿瘤手术患者的临床资料。结果全组41例中急诊手术7例,择期手术34例。根治性手术25例,姑息性切除手术9例,仅行短路手术7例。术后10例行ICU监护治疗;39例发生术后并发症,其中,呼吸道并发症27例,低蛋白血症24例,贫血15例,切口感染和切口裂开11例,心血管系统并发症5例。38例顺利出院,3例死亡。结论对于腹部肿瘤患者,超高龄并非手术禁忌证。积极预防和改善全身各系统器官功能,注意心肺功能的保护和营养状况的改善及选择正确的手术方案和时机都是手术安全有效的重要保障。

Objectlve To evaluate the perioperative treatments for patients over 80 years old with abdominal tumor. Methods Retrospective analysis of 41 cases with intact perioperative information of abdominal tumor patients over 80 years old from January 2004 to December 2009. Results Of all patients, 7 patients underwent emergency operation,34 patients accepted selective operation; 25 of them underwent radical resection and 9 of them underwent palliation resection, bypass operation was performed in 7 patients. After operation, 10 patients went into ICU; 39 patients had complications, included 27 eases respiratory complications, 24 cases hypoproteinemia, 15 cases anemia, 11 cases infection and disruption of incision, 5 cases cardiovascular complications, respectively. 38 patients were healing well completely except 3 patients died after operation. Conclusions For abdominal tumor patients, over 80 years old can not be surgical eontraindication. Surgery will be safe and effective while paying special attention to all the organ functions especially the cardiorespiratory function and nutritional status, and choosing the correct surgical program and opportunity.