高龄结直肠癌患者根治术后短期并发症及其影响因素  

Short-term postoperative complications and their influencing factors in elderly patients with colorectal cancer

作　　者：李永胜[1] 孙家和 郭书伟[1] 卢义康 刘洪洲[1] Yongsheng Li;Jiahe Sun;Shuwei Guo;Yikang Lu;Hongzhou Liu(Department of Colorectal Surgery,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院结直肠外科,山西长治046000

出　　处：《中华临床医师杂志（电子版）》2023年第9期962-967,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨高龄结直肠癌(CRC)患者根治术后短期并发症及其影响因素。方法将2017年1月至2022年10月长治医学院附属和平医院结直肠外科所有经手术根治的符合条件的76例CRC患者纳入研究,分析其临床病理变量,包括术前合并症、改良虚弱指数(mFI)、预后营养指数(PNI)等、手术及术后数据和结果。采用Clavien-Dindo并发症分级系统对术后短期并发症进行分级,并分析其发生短期重度并发症的危险因素。结果本组36例出现术后短期并发症,8例出现重度并发症;单因素结果表明,CRC患者术后出现重度并发症与ASA分级、mFI及PNI相关(P<0.05),而与性别、吸烟史、BMI、饮酒史、术前血红蛋白、CEA、cTNM分期与肿瘤位置无关(P>0.05);多因素结果表明,术后短期重度并发症与ASA分级、mFI及PNI与有关(P<0.05)。结论在进行严格术前评估的前提下,高龄结直肠癌患者根治手术是安全的。Objective To explore the short-term complications and their influencing factors in elderly patients after radical surgery for colorectal cancer(CRC).Methods All eligible CRC patients who had undergone radical surgery at the Colorectal Surgery Department of Heping Hospital Affiliated to Changzhi Medical College from January 2017 to October 2012 were included in the study,and their clinicopathological variables were analyzed,including preoperative complications,improved frailty index(mFI),prognostic nutrition index(PNI),and surgical and postoperative data and results.The Clavien-Dindo grading system was used to grade short-term postoperative complications,and the risk factors for the occurrence of short-term severe complications were identified by univariate and multivariate analyses.Results A total of 36 patients experienced short-term postoperative complications,of whom eight experienced severe complication.Univariate analysis showed that severe postoperative complications in CRC patients were associated with ASA grade,mFI,and PNI(P<0.05),but not with gender,smoking history,BMI,alcohol consumption history,preoperative hemoglobin,CEA,cTNM stage,or tumor location(P>0.05);Multivariate analysis demonstrated that short-term severe postoperative complications were associated with ASA grade,mFI,and PNI(P<0.05).Conclusion Under the premise of strict preoperative evaluation,radical surgery for colorectal cancer in the elderly is safe.

关 键 词：结直肠癌 老年患者 预后 预后营养指数 

分 类 号：R735.34[医药卫生—肿瘤]