外科治疗高龄肺癌的围术期处理

Perioperative Management in the Surgical Treatment of Advanced Lung Cancer

目的研究高龄肺癌患者外科治疗的围术期处理方法及效果。方法选取我院2014年4月至2016年4月期间收治的60例高龄肺癌患者,观察其外科治疗效果和术后并发症情况,比较治疗前后的QOL评分和ADL评分。结果治疗后,CR 38例(63.33%)、PR 15例(25.00%)、SD 6例(10.00%)、PD 1例(1.67%),治疗总有效率为88.33%。患者治疗后的QOL、ADL评分均明显高于治疗前(P<0.05)。术后随访发现肺部感染5例(8.33%)、气胸2例(3.33%)、肺不张1例(1.67%),呼吸功能衰竭1例(1.67%),并发症发生率为15.00%。结论高龄肺癌患者身体条件差,合并基础疾病多,严格掌握手术指征和适应症,对患者进行全面评估,做好围术期处理,可取得满意疗效。

Objective To study the perioperative method and effect of surgical treatment of elderly patients with lung cancer. Methods 60 cases of elderly patients with lung cancer admitted to our hospital from April 2014 to April 2016 were selected. The effect of surgical treatment and postoperative complications were observed, and the QOL scores and ADL scores before and after treatment were compared. Results There were 38 cases （63.33%） of CR, 15 cases （25.00%） ofPR, 6 cases （10.00%） of SD and 1 case （1.67%） of PD after treatment. The total effective rate of treatment was 88.33%. After treatment, the QOL score and ADL score were significantly higher than those before treatment （P 〈0.05）. During the postoperative follow-up, 5 cases （8.33%） of pulmonary infection, 2 cases （3.33%） of pneumothorax, 1 case （1.67%） of atelectasis and 1 case （1.67%） of respiratory failure were found. The incidence of complications was 15.00%. Conclusions As the elderly patients with lung cancer have poor physical condition combined with basic diseases, strict control of surgical indications, comprehensive evaluation of patients and good perioperative treatment can achieve satisfactory curative effect.