高龄肺癌58例的外科治疗及围手术期处理

Surgical treatment and perioperative period management for elderly lung cancer patients

目的 :探讨高龄肺癌外科治疗与围手术期处理的有关问题。方法 :回顾分析手术治疗的 5 8例 70岁以上肺癌病例。结果 :手术切除 5 6例 (96 6 % ) ,其中根治性切除 4 8例 (85 .7% ) ,姑息性切除 8例 (14 .3% )。探查2例 (3.4 % )。术后并发症 5 0例 (86 .2 % ) ,围手术期手术死亡 2例 ,病死率 3.4 %。结论 :高龄并非是决定肺癌患者采取手术治疗的禁忌。重视合并症的诊断和治疗、充分的术前准备、合理选择手术时机与手术方式、加强术中与术后监测和防治并发症 ,是减少术后并发症和病死率、提高根治性切除率。

Purpose:To explore the problems in the treatment of elderly patients suffering from lung cancer. Methods:58 cases of elderly patients aged over 70 who received operation for lung cancer during Oct. 1997 to Aug. 2002 were analyzed retrospectively.Results:56 cases underwent resections (resection rate 96.6%), of which 48 cases (82.8%) had radical resection and 8 cases (13.8%) palliative resection.2 cases (3.4%) had exploratory surgery. Postoperative complications were found in 50 cases (86.2%), of which 2 cases died during perioperation period(mortality rate 3.4%). Conclusions:Old age is not the major determining factor when considering surgical operation as the treatment for lung cancer patients. In order to enhance resection rates especially radical resection rate and survival rate, to diminish postoperative complications and mortality, and thus to improve the quality of life for the elderly lung cancer patients, a series of measures must be taken. First, diagnosis and treatment of the associated condition must be emphasized. Second, full preoperative preparations with appropriate choice of the time and procedure for operation. Finally, intensive monitoring during the preoperative period and prevention and treatment of postoperative complications are also important factors to be considered.