70岁以上老年患者实施妇科手术的围手术期观察

Perioperative observation of the gynecology surgery in elderly patients

目的观察70岁以上老年患者实施妇科手术的围手术情况,探讨围手术期处理的相关问题以及微创手术对老年妇女手术治疗的意义。方法回顾性分析2009年8月至2010年12月年龄>70岁老年患者的围手术期情况,结合患者康复情况,以术中出血量、平均住院天数和并发症发生率等探讨术前手术方式评估的必要性。结果纳入分析的283例患者中,术后发生一种并发症的患者比率为20.1%,发生一种以上并发症的患者比率为9.2%;92例患者选择微创手术,微创手术患者出血量、平均住院天数和并发症发生率均低于腹腔手术者,差异具有统计学意义(P<0.01)。所有患者均完成既定手术,经过治疗均痊愈出院。结论老年患者的脏器储备功能是影响围手术期风险的主要因素,在严格控制手术指征,积极治疗并发症的前提下,手术治疗对老年患者是安全的,微创手术在老年妇女中的开展有利于减少手术并发症。

Objective To observe perioperative issues on gynecology surgery in elderly patients aged 70 and above, and explore the related issues of perioperative management of minimally invasive surgery for surgical treatment of elderly women. Methods Retrospective study the perioperative issues of 283 patients on gynecology surgery aged 70 and above during 2009 to 2011. Results All the 283 patients were operated and discharged after treatment, 57 patients （20.1%） suffered single complication, while 9.2% patients had mutiple complication. For 92 patients chosen minimally invasive surgeries, their blood loss, the average hospitalization days and the incidence of complications were lower than those of the abdominal surgeries. Conclusion The gynecology surgery in elderly patients is a safer therapy and the minimally invasive surgery can reduce the complications.