高龄肺癌与食管、贲门癌围手术期治疗分析

Analysis about Perioperative Treatment of Patients Aged over 70 with Lung Cancer and Carcinoma of Esophagus and Cardia

目的 总结分析 86例 70岁以上肺癌与食管、贲门癌患者围手术期治疗情况 ,并探讨术后并发症的相关因素。方法 对 70岁以上 86例肺癌与食管、贲门癌患者的临床资料进行回顾分析。结果 同期 86例手术病例 ,肺癌占 66 2 8% ,食管、贲门癌占 3 3 72 % ;男性占83 72 % ,女性占 16 2 8% ,肺癌患者术前合并症和术后并发症发生率分别为 5 4 3 9%和 40 3 5 %。肺癌患者术前合并症发生率和术后并发症发生率分别是食管、贲门癌的 2 62倍和 2 3 4倍。肺癌死亡率为 3 5 1% ,食管、贲门癌组无死亡病例。本组结果提示肺切除术患者的术后并发症发生率明显高于实施探查术和食管、贲门癌切除术的患者 ;肺癌患者的术后并发症与术前合并症、肺功能情况有密切关系。结论 ( 1)高龄肺癌患者的术前合并症和肺功能中、重度低下是术后并发症发生率高的诱发因素。 ( 2 )实施肺切除手术患者的术后并发症发生率明显高于实施一般开胸手术患者 ,故对实施肺切除术的患者 ,要严格掌握手术适应证 :而相比较而言 ,对食管、贲门癌患者 ,在手术适应证掌握上 ,可以适当放宽限制。

Objective To analyze and conclude the perioperative treatment for 86 patients aged over 70 with lung cancer and carcinoma of esophagus and cardia, and to discuss the factors relative to the postoperative complications. Methods 86 patients aged over 70 with lung cancer and carcinoma of esophagus and cardia were analyzed retrospectively. Results The incidences of preand postoperative complications of lung cancer were 54.39% and 40.35 respectively. The incidence of the complications for patients who accepted pulmonary resection was higher than that of the others (P<0.05). The patients of lung cancer with preoperative complications had different incidence of postoperative complications, when compared with those without preoperative complications (P<0.05). The incidence of complications for the patients with lung cancer, whose pulmonary function decreased medially or heavily, was higher than that of the others (P<0.05). Conclusion (1) The high incidence of complications for the patients with lung cancer consists in the presence of preoperative complications and the decrease of pulmonary function. (2) The incidence of the complications for the patients given pulmonary resection was higher than that of the others. The operative indication should be screened strictly for the patients who accept pulmonary resection, while it may be wider for the patients with carcinoma of esophagus and cardia that are administered operation.