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目的 探讨老年结直肠癌患者的围手术期处理。方法 回顾性分析我院 1989～1999年间 186例 60岁以上结直肠癌患者外科处理的临床资料。结果 术前误诊 10 2例 ,有并存病15 2例。行根治性切除 12 9例 ,姑息性切除 14例 ,Hartmann术 15例。结肠造口 2 8例 ,术后出现并发症 5 2例 ,围手术期死亡 3例。 1、2、3年生存率分别为 89.8%、69.4%、61.3 %。结论 老年结直肠癌患者最好的治疗方法仍是手术切除。但早期诊断、合理的手术时机与手术方式、合理处理并存病 ,充分的术前准备和完善的麻醉 ,是减少并发症提高疗效的关键。
Objective To investigate the perioperative management of elderly patients with colorectal cancer. Methods The clinical data of 186 patients with colorectal cancer over the age of 60 from 1989 to 1999 were retrospectively analyzed. Results The preoperative misdiagnosis of 102 cases, 152 cases of coexisting disease. The radical resection of 12 9 cases, 14 cases of palliative resection, Hartmann operation in 15 cases. There were 28 cases of colostomy, 52 cases of postoperative complications and 3 cases of perioperative death. The 1, 2, 3 year survival rates were 89.8%, 69.4%, 61.3% respectively. Conclusion The best treatment for elderly patients with colorectal cancer is still surgical resection. However, early diagnosis, reasonable timing and operation of surgery, reasonable treatment of coexisting disease, adequate preoperative preparation and perfect anesthesia are the keys to reduce the complications and improve the curative effect.