高龄肺癌外科治疗65例分析

Analysis on surgical treatment of elderly lung cancer in 65 cases

目的探讨高龄肺癌的临床特征，力争提高手术切除率，改善患者预后。方法对我院2003年2月-2013年2月手术治疗的65例高龄肺癌病例进行回顾分析。结果本组65例均为进展期肺癌，右侧肺癌38例，左侧肺癌27例；中央型36例，周围型29例。肿瘤直径〈3cm者19例，≥3cm者46例；手术切除59例，切除率90．8％。术后病理：鳞状细胞癌29例，腺癌26例，小细胞癌3例，混合型4例，支气管类癌3例。并发症发生率32．3％；3年生存率56．9％，5年生存率38．5％。结论高龄肺癌患者手术适应证应慎重选择，早期诊断、选择合理的手术方式、术前积极处理伴发病、术后防治并发症及加强护理是患者预后的关键。

Objective To investigate the clinical characteristics of elderly lung cancer in order to increase the rate of surgical removal and improve the prognosis of patients. Methods 65 cases of elderly lung cancer treated with surgery in our hospital from February 2003 to February 2013 were retrospectively analyzed. Results 65 cases were all advanced lung cancer, of which 38 cases were right lung cancer, 27 cases were left lung cancer; 36 cases were central type, 29 cases were peripheral type. 19 cases with tumor diameter smaller than 3cm, 46 cases with tumor diameter greater than 3cm; 59 cases were surgical removal, the rate of surgical removal was 90.8%. The postoperative pathology showed that there were 29 cases of squamous cell carcinoma, 26 cases of adenocarcinoma, 3 cases of small cell carcinoma, 4 cases of mixed type, 3 cases of bronchial carcinoid. The complication rate was 32.3%.The 3-years survival rate was 56.9%, 5 years survival rate was 38.5%. Conclusion Surgical indications for patients of elderly lung cancer should be carefully chosen, early diagnosis, choice of appropriate surgical approach, preoperative active handling of concomitant disease and postoperative prevention and treatment of complications and strengthening nursing are the key to the prognosis of patients.