高龄大肠癌术后并发症防治体会(附86例报告)  

Experience in prevention and cure of postoperative complications of colorectal cancer in advanced age

作　　者：孔刚[1] 龚志军[1] 郭建平[2] 卿笃桔[1] 梁永全[1] 刘虹[1] 

机构地区：[1]江门市中心医院胃肠外科,529000 [2]广东省粤北人民医院胃肠外科,512025

出　　处：《岭南现代临床外科》2009年第3期176-177,181,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的总结高龄大肠癌患者术后并发症防治的经验。方法回顾性分析手术治疗的86例70岁以上老年人大肠癌病例资料。结果所有患者均行手术治疗(13例因并发结直肠梗阻而行急症手术),其中64例(73.3%)属根治性切除(D3),13例肿瘤姑息性切除,6例仅永久性结肠造口术,3例剖腹探查加肿瘤种植结节或转移淋巴结活检术。总切除率为89.5%。无手术死亡病例。15例发生并发症共21例次,占17.4%,其中肺部感染7例、切口感染7例、切口裂开3例、尿潴留1例,心力衰竭2例、脑血管意外1例等,无吻合口瘘。本组获得随访77例,其中1年生存率是85.7%(66/77),3年生存率70%(54/77)5年生存率41.5%(32/77)。结论做好高龄大肠癌的术前准备(包括内科伴发病的处理),正确掌握不同术式的适应证和手术操作以及术后处理,可有效提高手术成功率,降低死亡率和术后并发症的发生。Objective To summarize the experience in prevention and cure of postoperative complications of eolorectal cancer in advanced age. Methods All cases under went operative treatment. Among them, radical resection （D3）, palliative resection of tumor, permanent colostomy and exploratory laparotomy plus planted nodules of tumor or me tastatic lymph mode biopsy were in 64, 13,and 13 cases respectively. Total resection rate was in 89.5%. Results In this group, no operative death was found. Postoperative complications were found in 21 times of 15 cases （17.4%）. Among them, pulmonary infection, incisional infection, incisional dehiscence, urinary retention, heart failure and cerebraal vascular accidence were in 7,7,3,2 and 1-case respectively. No anastomotic leakage was found. Follow-up was got in 77 cases. Follow-up rate was in 89.5%. The 1,3 and 5-year survival rates wrer in 85.7%（66/77）,70%（54/77） and 41.5%（32/77）respectively. Conclusion A good preoperative preparation eineluding management of concomitant diseases of internal medicine ,correct operative technic and postoperative management are important measures to improve successful rate of operation and to reduce martality and postoperative complication rate for eolorectal cancer in advanced age.

关 键 词：高龄 大肠癌 并发症 

分 类 号：R735.3[医药卫生—肿瘤]