老年胃癌患者术后并发症的影响因素分析

Factors analysis of postoperative complications of elderly patients with gastric cancer

目的：探讨老年胃癌患者术后并发症的影响因素。方法选择2009年1月至2012年12月在普外科接受手术治疗的老年胃癌患者（年龄≥65岁）115例，根据术后是否发生并发症分为两组，术后发生并发症63例，其余52例术后未发生并发症，回顾性分析两组患者的一般资料，包括年龄、胃癌分期、是否行根治手术、是否联合脏器切除和手术时间等，总结术后发生并发症的相关因素。结果术后并发症影响因素中，有无并发症组患者年龄分布、胃癌分期、是否行根治手术、是否联合脏器切除等差异均无统计学意义（χ^2=3.113、P =0.078，χ^2=0.465、P =0.495，χ^2=0.518、P =0.472，χ^2=0.303、P=0.582），术后未发生并发症组与发生并发症组手术时间≤3 h 者分别为30例（57.9％）和51例（81.0％），＞3 h 者分别为22例（42.3％）和12例（19.1％），两组手术时间比较差异有统计学意义（χ^2=6.326，P =0.012）。结论手术时间是老年胃癌患者术后并发症的主要影响因素，因此，在保证手术质量的前提下，尽可能缩短手术时间是降低老年胃癌患者术后并发症发生率最有效的方法。

Objective To investigate the factors of postoperative complications of elderly patients with gastric cancer. Methods One hundred and fifth elderly patients with gastric cancer were selected as our subjects,who were underwent surgical treatments in general surgery department Jiangsu Shengze Hospital from Jan. 2009 to Dec. 2012. The general informations including age,staging of gastric cancer,radical operation performed or not,resection combined with other organs and operation periods were recorded. Results There were no significant differences between postoperative complications patients in terms of age,staging of gastric cancer,radical operation performed or not,resection combined with other organs（ χ^2 = 3. 113,P = 0. 078,χ^2= 0. 465,P = 0. 495,χ^2 = 0. 518,P = 0. 472,χ^2 = 0. 303,P = 0. 582）. The cases with operation periods 〈 3 h in complication group and no complication group were 30（57. 9% ）and 51（81. 0% ）,and the operation periods〉 3 h were 22（42. 3% ）and 12（19. 1% ）respectively,and the difference was significant（ χ^2 = 6. 326,P= 0. 012）. Conclusion Operation period is the main influencing factor of the elderly patients with gastric cancer. Therefore,reducing operation period under ensuring operation quality is more efficiency to decrease the complication.