高龄大肠癌患者并发急性肠梗阻的治疗及预后影响因素分析

摘要

目的 探讨老年肠道肿瘤导致肠梗阻患者的治疗方法,分析预后的相关因素.方法 回顾性分析2000年6月至2005年6月我科治疗的51例大肠癌并发急性肠梗阻患者的临床资料,分析术前各临床指标与术后5年生存率的关系,并进行单因素生存分析及多因素Cox比例风险模型分析.结果 大肠癌并急性肠梗阻患者预后单因素分析,在性别、血白蛋白水平、贫血、肿瘤部位、肿瘤病理、Dukes分期,手术方式及术后化疗与否等因素中,年龄、白蛋白水平、贫血与否、肿瘤部位与生存率无明显相关性(P＞0.05)；而肿瘤细胞病理、Dukes分期、手术方式及术后化疗与否与生存率明显相关(P＜0.05),差异具有统计学意义.多变量分析结果表明早期行根治术是影响高龄大肠癌并肠梗阻患者预后的独立因素(P＜0.05).结论 在严格掌握适应证的情况下,尽早把握手术时机,争取行一期切除吻合术可提高患者生存率,提高临床疗效.%Objective To explore the effective clinical treatment for colorectai carcinoma with acute obstruction in elderly patients, and to analyze the clinical factors associated with the prognosis. Methods A retrospective analysis was performed in 51 patients of colorectai carcinoma complicated with acute obstruction in our department from June 2000 to June 2005. The relationship between the clinical index before treatment and the five year survival rate was analyzed. And univariate and multivanate Cox proportional hazard model analysis was conducted. Results Univariate analysis revealed that age, albumin levels, anemia and tumor site showed no significant correlation with the five year survival rate (P>0.05), and factors such as tumor pathology, Dukes stage, surgery and postoperative chemotherapy was significantly related with the survival rate (P＜0.05). Multivanate analysis showed that early surgery is the independent prognostic factor of colorectai carcinoma with acute obstruction in elderly patients (P＜0.05). Conclusion For elderly patient with colorectai carcinoma complicated with acute obstruction, the survival rate and clinical effect can be improved by grasping the operation time and making one stage resection, following the indications strictly.