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目的 :探讨围手术期老年胃癌患者并存病的治疗。方法 :回顾性分析 1998年 1月～ 2 0 0 2年 12月间收治 5 8例 65岁以上有并存病的胃癌患者的外科治疗。结果 :并存呼吸系统疾病 2 9例 ,心脏病 3 2例 ,高血压 2 0例 ,贫血 18例 ,糖尿病 10例 ,肾功能异常 8例 ,肝功能异常 11例 ,低蛋白血症 5例。术后并发症有吻合口瘘 2例 ,腹腔内出血 3例 ,应激性溃疡 2例 ,肠梗阻 3例 ,腹腔脓肿 3例 ,残胃排空迟缓症 4例 ,心功能不全 1例 ,伤口感染 6例 ,肺部感染 2例。围手术期死亡 2例。结论 :虽然并存病增大了手术风险 ,但术前全面了解病情 ,加强并存病的围手术期治疗可大大提高手术成功率 ,降低死亡率和并发症发生率
Objective: To investigate the treatment of co-morbidity of perioperative elderly patients with gastric cancer. Methods: A retrospective analysis of surgical treatment of 58 patients with gastric cancer over the age of 65 with degenerative disease was performed between January 1998 and December 2002. Results: There were 29 cases of concurrent respiratory diseases, 32 cases of heart disease, 20 cases of hypertension, 18 cases of anemia, 10 cases of diabetes mellitus, 8 cases of abnormal renal function, 11 cases of abnormal hepatic function and 5 cases of hypoalbuminemia. Postoperative complications were anastomotic leakage in 2 cases, intra-abdominal bleeding in 3 cases, stress ulcer in 2 cases, intestinal obstruction in 3 cases, abdominal abscess in 3 cases, residual gastric emptying in 4 cases, heart failure in 1 case, wound infection 6 cases, 2 cases of lung infection. Perioperative death in 2 cases. CONCLUSION: Although concurrent disease increases the risk of surgery, the preoperative comprehensive understanding of the disease and the improvement of perioperative treatment of comorbidities can greatly improve the success rate of surgery and reduce the incidence of mortality and complications