高龄患者前列腺癌根治术的围手术期并发症分析

摘要

目的 采用标化评分系统分析高龄患者(≥70岁)前列腺癌根治术(RP)围手术期并发症发生率和严重程度.方法 选取2006年1月至2011年6月242例前列腺癌根治术患者,其中≥70岁163例,＜ 70岁79例.系统性收集患者术前疾病特征和围手术期并发症情况,依ClavienDindo标准将围手术期并发症按严重程度分级.将并发症发生率与严重程度在高龄组(≥70岁)和对照组(＜ 70岁)间进行对比分析.结果 高龄组共47例(23.5％)患者发生围手术期并发症,其中严重并发症(Ⅲ度及以上)8例(4.0％).对照组共18例(22.7％)患者发生并发症,其中严重并发症4例(5.0％),差异无统计学意义(p＞0.05).高龄组患者围手术期输血者(36例)较对照组(7例)多,差异有统计学意义(x2 =6.37,P ＜0.05)；深静脉血栓形成、术中直肠损伤、术后谵妄发生率高于对照组,但差异均无统计学意义.结论 在具有丰富经验的中心,前列腺癌根治术在高龄患者中仍是较为安全可行的.%Objective To evaluate the incidence and severity of perioperative complications in elderly patients with radical prostatectomy (RP).Methods A total of 242 patents underwent RP for prostate cancer were retrospectively assessed,whose clinicopathologic factors and perioperative complications were retrieved from the medical records.The mean age in the elderly group (n =163) and control group (n =79) were (73.2 ± 2.4) and (63.2 ± 4.8) years,respectively.The clinicopathologic factors including Charlson comorbidity index and preoperative prostate specific antigen were statistically significant different.The difference of clinicopathologic factors and perioperative complications between the elderly group (≥70years old) and control group were statistically analyzed using the SPSS 17.0.Results The incidence of perioperative complications was 23.5％ in the elderly group and 22.7％ in the control group.Except for gross hematuria (there were 12 cases in elderly group and 1 case in control group,respectively,x2 =3.89,P ＜ 0.05) and perioperative transfusion (there were 36 cases in elderly group and 7 cases in control group,respectively,x2 =6.37,P ＜ 0.05),there was no significant difference in each kind or total of perioperative complications.Conclusion The elderly patients underwent RP in experienced center are not associated with higher or more serious perioperative complications.