老年人肝癌肝切除术后预后分析  

Analysis of perioperative and long-term outcome of hepatic resection for hepatocellular carcinoma in the elderly

作　　者：黄耿文[1] 杨连粤[1] 鲁伟群[1] 

机构地区：[1]中南大学湘雅医院普外科,长沙市410008

出　　处：《中华老年医学杂志》2005年第8期577-579,共3页Chinese Journal of Geriatrics

基　　金：国家"十五"科技攻关项目(2001BA703B04)

摘　　要：目的探讨患者年龄对肝癌肝切除术近远期预后的影响。方法回顾性分析52例老年肝癌肝切除术患者,与同期215例非老年肝癌患者进行对比,结合随访资料分析年龄对近期并发症和远期存活率的影响。结果老年组并发症发生率为32.7%,住院天数(29.9±4.3)d,显著高于非老年组的18.6%和(24.7±6.1)d,差异均有统计学意义(均为P<0.05)。单因素分析显示,年龄、肝门阻断、出血量和术中输血与术后并发症的发生有关。多因素分析显示,年龄、肝门阻断和术中输血是决定术后并发症的3个独立的预测指标。老年组1、3、5年总存活率分别为82.5%、55.3%、49.1%,非老年组分别为63.9%、38.2%、27.7%,老年组的总存活率高于非老年组,差异有统计学意义(P<0.05)。结论对老年人肝癌应采取积极手术治疗的态度。Objective To study the effect of age on the perioperative and long-term outcome of hepatic resection for hepatocellular carcinoma. Methods Fifty two cases of elderly patients with hepatic resection for hepatocellular carcinoma were analysised retrospectively. Results The morbidity rate and in-hospital duration in elderly group were 32.7 ％ and （29.9 ± 4.3）d respectively,higher than 18.6 ％ and （ 24.7 ± 6.1 ） d in non-elderly group （P 〈 0.05 ） . Single-variant analysis showed that age, portal clamping and blood loss and transfusion were associated with postoperative complications. Multivariate stepwise regression analysis revealed that the age, portal clamping and blood transfusion were the independent risk factors for the morbidity rate of resections of hepatocellular carcinoma. The 1-year, 3-year, 5-year overall survival rate was 82.5%, 55.3% and 49.1% in elderly group and 63.9%、38.2% and 27.7% in non-elderly group （all P〈 0. 05）.Conclusions Aggressive operative treatment is necessary for hepatocellular carcinoma in the elderly.

关 键 词：老年人 肝癌 肝切除术 预后 治疗 

分 类 号：R735.7[医药卫生—肿瘤]