41例高龄结直肠癌根治性手术的危险因素
摘要
目的:分析高龄结直肠癌患者手术的危险因素,进行相关干预,提高根治性手术率,改善总体预后。方法:回顾性分析75岁以上行根治性手术的41例结直肠癌患者的临床资料,对术前并基础疾病、术中情况及术后并发症等因素进行分类统计。结果:术前合并基础疾病共26例(63.4%),包括糖尿病、高血压、冠心病、慢性支气管炎、贫血、低蛋白血症等。术中出血量大于250 mL 13例,手术时间超过200 min 12例,联合器官切除5例。术后并发症21例(51.2%),包括肺部感染、支气管哮喘、急性呼吸功能衰竭、心功能不全、心肌梗死、吻合口瘘、感染、下肢静脉血栓形成等。结论:年龄大于80岁、合并基础疾病、低血红蛋白(贫血)、低蛋白血症、手术时间超过200 min是高龄结直肠癌患者根治性手术的危险因素。
引文
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[12]刁德昌,卢新泉,万进,等.64例85岁以上超高龄结直肠癌术后并发症相关因素分析[J].中华胃肠外科杂志,2015,18(12):1274-1276.
[2]Fukata S,Ando M,Amemiya T,et al.Postoperative function follow-ing radical surgery in gastric and colorectal cancer patients over80 years of age-an objection to"ageism"[J].Nagoya J Med Sci,2012,74(3-4):241-251.
[3]Korytova LI,Sandalevskaya AG,Krasnikoval,VG,et al.Immediateresults of combined therapy for local recurrences of rectal cancer[J].Voprosy Onkologii,2015,61(1):52-56.
[4]杨玲,柏愚,拓西平,等.高龄老年人群结肠癌筛查的荟萃分析[J].中华消化内镜杂志,2015,10(32):653-658.
[5]Tsar'kov PV,Nikoda VV,Stamov VI,et al.The efficacy of the mul-tidisciplinary approach in colorectal cancer surgery in elderly pa-tients[J].Khirurgiia(Mosk),2012,68(2):4-13.
[6]肖成志,张永梅,方萌.围手术期心房纤颤患者的治疗与管理[J].中国实用医药,2013,8(18):183-185.
[7]吴丽娜,刘蕊,李莎,等.结直肠癌患者围手术期血糖影响因素分析[J].山东医药,2013,53(22):47-48.
[8]Mc Bride R,Dasari B,Epanomeritakis E,et al.Immediate and late outcomes after colorectal cancer surgery in elderly patients[J].Gut,2013,62(7):A25.
[9]刘猛,王今.80岁以上结直肠癌患者手术治疗效果分析[J].临床与病理杂志,2016,36(7):935-940.
[10]廖占国.结直肠癌术后并发症危险因素分析[J].山东医药,2014,54(22):61-62.
[11]张清泉,黄彬,任炜,等.结直肠癌手术并发症及其影响因素分析[J].中华临床医师杂志,2013,7(23):10444-10447.
[12]刁德昌,卢新泉,万进,等.64例85岁以上超高龄结直肠癌术后并发症相关因素分析[J].中华胃肠外科杂志,2015,18(12):1274-1276.