老年胃癌患者手术治疗风险与肿瘤分期、术前合并症数、手术根治性及术后并发症数等疗效评价研究

Evaluation on Curative Effect of Surgery Risks and Tumor Stage, Preoperative complications, Radical Surgery and Postoperative Complications in Elderly Patients with Gastric Cancer

目的探究老年胃癌患者进行手术治疗的相关危险因素,进一步合理指导临床手术治疗,改善患者预后生活质量。方法选取2014年1月—2016年12月在该院接受手术治疗的老年胃癌患者82例,采用随机数字分配法将胃癌患者40例作为对照组,胃癌患者42例,作为观察组,对比影响两组胃癌患者手术风险的相关因素。结果在两组术前合并症的比较中发现,观察组存在较为复杂的术前合并症,术前合并症以内科疾病为主,主要包括了高血压(42.90%)、糖尿病(17.00%)、冠心病(24.00%)、肺部疾病(31.00%)等,与对照组相比差异有统计学意义(P<0.05);脑部疾病(4.80%)、肝功能异常(9.50%)、电解质紊乱(11.90%)等合并症与对照组相比差异无统计学意义(P>0.05)。在两组术后合并症的比较中发现,与对照组术后并发症相比,观察组肺部感染(24.43%)、心律失常(16.67%)明显增加,组间差异有统计学意义(P<0.05);腹腔感染、吻合口瘘差异无统计学意义(P>0.05)。结论老年胃癌患者有自身临床表现,在对老年患者进行手术治疗前后应全面考虑影响手术及预后效果的影响因素,降低风险,提高老年胃癌患者手术后的生活质量。

Objective This paper tries to explore the related risk factors for surgery in elderly patients with gastric cancer treatment, to further guide clinical surgical treatment, improve the prognosis life quality of patients. Methods A total of 82 elderly patients with gastric cancer who underwent surgical treatment from January 2014 to December 2016 were enrolled in this study and were randomly divided into the control group of 40 cases and the observation group of42 cases. Relevant factors of surgical risks in patients were compared. Results In the comparison of preoperative complications, it was found that there were more complicated preoperative complications in the observation group. The preoperative complications were mainly medical diseases, including hypertension（42.90%）, diabetes mellitus（17.02%）,coronary heart disease（24.00%）, and lung disease（31.00%）, which was significantly different from the control group（P0.05）; brain disease（4.80%）, abnormal liver function（9.50%）, electrolyte disorder（11.90%）, and the differences were not significant（P0.05）. Compared with the control group, the pulmonary infection（24.43%） and the arrhythmia（16.67%） in the observation group were significantly higher than those in the control group（P0.05）. There was no significant difference between the two groups in intraperitoneal infection and anastomotic leakage（P0.05）. Conclusion Elderly patients with gastric cancer have their own clinical manifestations, the impact factors of surgery and prognostic in the elderly patients before and after surgical treatment should be fully considered, so as to reduce the risk and improve the quality of life of elderly patients with gastric cancer after surgery.