对老年胃癌穿孔患者术后预后影响因素探究

Exploration of influencing factors of prognosis on elderly patients with perforation of gastric cancer

目的对老年胃癌穿孔手术患者进行回顾性分析,以对患者预后的多个相关影响因素进行探讨。方法选取笔者所在医院2000年1月～2012年1月收治的老年胃癌穿孔患者作为研究对象,所有患者的病历经清楚完整。采取单因素Cox回归分析对预后相关影响因素进行研究,以患者死亡作为失效时间(1=死亡,0=存活),对年龄、性别、合并疾病、TNM分期、术式选择、并发症发生情况和术后存活时间进入回归分析。结果 TNM分期、术式选择和合并疾病3个变量进入到方程当中,差异有统计学意义(P<0.05)。而其他变量则与生存时间的差异均无统计学意义(P>0.05)。结论在患者机体状况条件允许,即腹腔无严重的感染、中毒症状不明显、无严重内科疾病无法耐受大型疾病下,笔者建议采用一期胃癌根治术。

Objective Elderly patients with perforation of gastric cancer were analyzed retrospectively to explore the related influencing factors of prognosis. Methods Elderly patients with perforation of gastric cancer in our hospital from January 2000 to January 2012 were selected as participants and all of the medical records were clear and complete. Univariate Cox regression analysis was adopted to the related influencing factors of prognosis.Death of patients were as failure time（1=dead, 0=alive）,the ages,sex,merge disease, TNM stage,operation selection,complications and postoperative survival time of patients were deal with regression analysis. Results The three variables in TNM stage,operation selection and complication were entered into the regression equation and the difference was statistically significant（P 〈 0.05）.The difference between other variables and survival time was no statistically significant（P 〉 0.05）. Conclusion The author suggests using one stage gastric cancer radical mastectomy on condition that patients with no serious abdominal cavity infection,poisoning symptoms unknown,no serious medical illness and unable to withstand large disease.