高龄食管癌和贲门癌患者手术治疗的临床分析

摘要

Objective To explore the operation feasibility in the elderly patients (>75 years old )with esophageal and cardiac cancer and the cautions in the perioperative period.Methods The surgery data of 37 cases of elderly patients (>75 years old)with esopha-gus and cardiac cancer (study group)in our hospital from Jul 2012 to Jul 2014 were collected and analyzed,and their postoperative compli-cations were compared with those of 61 patients (<65 years old)with esophageal and cardiac cancer (control group)treated with the same procedure.Results The 37 elderly patients with esophageal and cardiac cancer all rode out the perioperative period with no death.There had no statistical difference between the study group and the control group in the complication of anastomotic fistula (P>0.05 ),but the differences in the complications of pulmonary inflammation and atelectasis,respiratory failure and arrhythmia between the two groups were sta-tistically significant (P<0.05 ).Conclusion For the elderly patients (>75 years old)with esophageal and cardiac cancer,surgical treat-ment is feasible with higher risk of serious complications.It is essential to cautiously choose the suitable therapies for those patients and to strengthen management of the perioperative period.%目的：探讨高龄食管癌和贲门癌患者手术的可行性及围手术期注意事项。方法总结分析2012年7月至2014年7月收治的37例高龄（＞75岁）食管和贲门癌患者（研究组）外科手术治疗的临床资料，并与同期手术治疗的61例（＜65岁）食管和贲门癌患者（对照组）的术后并发症进行对比研究。结果研究组患者均平稳度过围手术期，无一例死亡；研究组与对照组并发症中吻合口瘘差异无统计学意义（P＞0.05），但肺不张与肺炎、呼吸衰竭和心律失常差异有统计学意义（P＜0.05）。结论高龄（＞75岁）食管癌和贲门癌患者外科手术治疗可行，但易出现并发症，选择手术治疗需谨慎，加强围手术期管理很重要。