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目的探讨老年胃癌患者的围术期处理经验。方法回顾性分析1996年7月至2007年6月181例60岁以上接受手术治疗的胃癌病例。结果181例患者中合并糖尿病27例,慢性支气管炎37例,阻塞性通气障碍12例,贫血79例,低蛋白血症28例,高血压病63例,冠心病72例。无术前死亡病例,术后出现并发症147例次:胰漏1例,腹水形成13例,伤口裂开1例,伤口感染3例,心衰2例,心绞痛3例,血压升高79例,心律失常57例,血糖升高34例,肺部感染18例,急性胰腺炎1例;死亡3例(1.66%)。结论术前合并症增加了手术的风险性,但术前全面了解病情,加强对其围手术期处理可提高手术的安全性,降低手术死亡率和并发症发生率。
Objective To investigate the perioperative management of elderly patients with gastric cancer. Methods A retrospective analysis of 181 cases of gastric cancer over 60 years old surgically treated from July 1996 to June 2007 was performed. Results Among the 181 patients, 27 were complicated by diabetes, 37 with chronic bronchitis, 12 with obstructive ventilatory disorder, 79 with anemia, 28 with hypoproteinemia, 63 with hypertension and 72 with coronary heart disease. No preoperative death cases, postoperative complications 147 cases: 1 case of pancreatic leakage, ascites formation in 13 cases, 1 case of wound rupture, wound infection in 3 cases, 2 cases of heart failure, angina in 3 cases, 79 cases of elevated blood pressure , 57 cases of arrhythmia, 34 cases of elevated blood sugar, 18 cases of pulmonary infection, 1 case of acute pancreatitis; 3 cases died (1.66%). Conclusion Preoperative complications increase the risk of surgery, but a comprehensive understanding of the disease preoperatively, to strengthen its perioperative management can improve the safety of surgery and reduce the incidence of surgical mortality and complications.