高龄食管癌患者进行手术治疗的可行性分析  

Feasibility Analysis of Surgical Treatment for Elderly Esophageal Cancer Patients

作　　者：莫宝森 周华富[2] 陈尚威 刘俊 Mo Bao-sen;Zhou Hua-Fu;Chen Shang-wei;Liu Jun(rd Hospital of the PLA Joint Logistic Support Force,Nanning 530021,Guangxi,China;The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China)

机构地区：[1]中国人民解放军联勤保障部队第九二三医院,广西南宁530021 [2]广西医科大学第一附属医院,广西南宁530021

出　　处：《中外医药研究》2023年第3期45-47,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨高龄食管癌患者进行手术治疗的可行性。方法:选取2012年8月—2017年8月在中国人民解放军联勤保障部队第九二三医院及广西医科大学第一附属医院行食管癌切除手术的134例患者作为研究对象,将≥75岁患者归为高龄组(52例),<75岁患者归为非高龄组(82例)。比较两组患者临床资料、术前合并症、手术相关情况、术后并发症,分析高龄食管癌患者的相关预后因素。结果:高龄组患者心功能不全、呼吸功能不全、贫血、低蛋白血症、糖尿病发生率高于非高龄组,差异有统计学意义(P<0.05)。两组手术时间、术中出血量、术后引流量、术后拔除胸腔引流管时间、ICU住院时间、总住院时间比较,差异无统计学意义(P>0.05)。两组术后肺部感染、肺不张、吻合口瘘、胸腔积液、喉返神经损伤、切口感染、乳糜胸发生率比较,差异无统计学意义(P>0.05);高龄组心功能不全、呼吸衰竭发生率高于非高龄组,差异有统计学意义(P<0.05)。单因素素Cox回归分析表明,TNM分期及术前合并症是食管癌患者的预后相关危险因素;多因素Cox回归分析表明,TNM分期可作为高龄食管癌患者独立的预后因子。结论:高龄食管癌患者经围术期严格评估,优化手术流程,可进行手术治疗,TNM分期是影响患者独立的预后因子。Objective:To explore the feasibility of surgical treatment for elderly patients with esophageal cancer.Methods:One hundred and thirty-four patients who underwent esophageal cancer resection in the 923rd Hospital of the PLA Joint Logistic Support Force and the First Affiliated Hospital of Guangxi Medical University from August 2012 to August 2017 were selected as study subjects,and patients≥75 years old were categorized as the senior group(fifty-two cases)and patients<75 years old were categorized as the non-senior group(eighty-two cases).The clinical data,preoperative comorbidities,surgery-related conditions,and postoperative complications of the two groups were compared,and the prognostic factors related to the elderly esophageal cancer patients were analyzed.Results:The incidence of cardiac insufficiency,respiratory insufficiency,anemia,hypoproteinemia,and diabetes mellitus was higher in the senior group than in the non-senior group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of operative time,intraoperative bleeding,postoperative drainage,postoperative chest drains removal time,ICU stay,and total hospital stay(P>0.05).There was no statistically significant difference in the incidence of postoperative pulmonary infection,pulmonary atelectasis,anastomotic fistula,pleural effusion,laryngeal recurrent nerve injury,incisional infection,and celiac disease between the two groups(P>0.05).The incidence of cardiac insufficiency and respiratory failure was higher in the senior group than in the non-senior group,and the difference was statistically significant(P<0.05).Single-factor vegetative Cox regression analysis showed that TNM stage and preoperative comorbidities were prognosis-related risk factors for patients with esophageal cancer.Multi-factor Cox regression analysis showed that TNM stage could be used as an independent prognostic factor for senior esophageal cancer patients.Conclusion:Elderly esophageal cancer patient

关 键 词：食管癌 高龄 手术治疗 

分 类 号：R73[医药卫生—肿瘤]