衰弱对老年胃癌患者围术期的影响  

Effect of frailty on perioperative period of elderly patients with gastric cancer

作　　者：孙燕婷 薛荣亮[2] 王宁[2] 焦宏博[3] 吴畏 SUN Yanting;XUE Rongliang;WANG Ning;JIAO Hongbo;WU Wei(Anesthesiology Department,Baoji High-tech Hospital,Baoji 721013;Anesthesiology Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;Oncology Department,Baoji Central Hospital,Baoji 721000,China)

机构地区：[1]宝鸡高新医院麻醉科,陕西宝鸡721013 [2]西安交通大学第二附属医院麻醉科,陕西西安710004 [3]宝鸡市中心医院肿瘤内科,陕西宝鸡721000

出　　处：《临床医学研究与实践》2021年第31期57-59,66,共4页Clinical Research and Practice

基　　金：宝鸡市卫生健康委员会2019年度科研计划立项课题(No.2019-03)。

摘　　要：目的采用改良衰弱指数(mFI)探讨衰弱对老年胃癌患者围术期的影响。方法选取2018年10月至2019年12月于我院择期行远端胃癌根治手术的老年患者90例,根据患者术前的mFI将其分为非衰弱组(mFI<3分,50例)和衰弱组(mFI≥3分,40例)。比较两组的一般资料、入院时的各项生化指标及术后恢复情况;分析mFI与美国麻醉医师协会(ASA)分级的相关性。结果衰弱组的年龄明显高于非衰弱组(P<0.05)。Spearman秩相关性分析显示,mFI与ASA分级呈正相关(P<0.05)。入院时,衰弱组的总蛋白、肌酐水平明显低于非衰弱组(P<0.05)。衰弱组的瑞芬太尼、丙泊酚用量明显少于非衰弱组,血管活性药物使用率明显高于非衰弱组(P<0.05)。衰弱组的术后苏醒时间、恢复室停留时间、术后下地时间、肛门排气时间、总住院时间明显长于非衰弱组,总花费明显多于非衰弱组(P<0.05)。结论衰弱患者术中管理相对困难,术后转归差。mFI与ASA呈正相关,是评估老年患者围术期风险程度的有力参考指标。Objective To explore the influence of frailty on the perioperative period of elderly patients with gastric cancer by modified frailty index(mFI).Methods A total of elderly patients who underwent elective radical distal gastric cancer surgery in our hospital from October 2018 to December 2019 were selected,and the patients were divided into non-frailty group(mFI<3 points,50 cases)and frailty group(mFI≥3 points,40 cases)according to their preoperative mFI.The general information,biochemical indexes at admission and postoperative recovery of the two groups were compared;the correlation between mFI and American society of anesthesiologists(ASA)grade was analyzed.Results The age of the frailty group was significantly higher than that of the non-frailty group(P<0.05).Spearman rank correlation analysis showed that mFI was positively correlated with ASA classification(P<0.05).At admission,the levels of total protein and creatinine in the frailty group were significantly lower than those in the non-frailty group(P<0.05).The dosage of remifentanil and propofol in the frailty group were significantly lower than those in the non-frailty group,while the utilization rate of vasoactive drugs was significantly higher than that in the non-frailty group(P<0.05).The postoperative recovery time,recovery room residence time,postoperative grounding time,anal exhaust time and total hospital stay in the frailty group were significantly longer than those in the non-frailty group,and the total cost was significantly higher than that in the non-frailty group(P<0.05).Conclusion The intraoperative management of frailty patients is relatively difficult,and the postoperative outcome is poor.mFI is positively correlated with ASA,which is a powerful reference index to evaluate the perioperative risk of elderly patients.

关 键 词：衰弱 老年胃癌患者 麻醉 预后 

分 类 号：R592[医药卫生—老年医学]