高龄胃癌68例治疗分析

摘要

Objective: To study the operative method and perioperative period management of gastric carcinoma in the elderly patients.Method:From December 1987 to January 2000, 68 cases of gastric carcinoma aged 70 years old and over were analyzed retrospectively.Results: Gastric carcinoma in the elderly were usually occult in onset, with fullness and aching of upper abdomen, obstruction and anemia as the common clinical manifestation. Most of these cases had coexistent diseases. Among them, 39 cases underwent radical gastrectomy, 18 cases received palliative resection. The postoperative complication rate was 25.0% and mortality rate 5.3%.Conclusion: Early diagnosis and treatment is important in gastric carcinoma of the elderly. Besides the nutritional spport during the perioperative period, adequate preoperative care, timely operation, choice of operative procedure, perfect anesthesia and cardiopulmonary mornitoring are important in reducing complication and mortality rates and in improving the efficacy of curative resection.%目的：探讨高龄胃癌患者的手术治疗及围手术期的处理。方法：回顾性分析了1987年12月至2000年1月68例70岁以上胃癌病人的外科治疗经过。结果：高龄胃癌起病隐匿，以上腹部饱胀、隐痛、梗阻及贫血为主要临床表现，大部分病人有合并症。其中根治性切除39例，姑息性切除18例，切除率83．8％。术后并发症发生率25．0％，病死率7.3％。结论：对高龄胃癌患者，应尽可能做到早期诊断，及时治疗。除加强围手术期营养支持外，充分的术前准备，适当的手术时机及手术方法的选择，完善的麻醉及心肺功能监测，精细的手术操作，是提高根治性切除，减少并发症，降低病死率的关键。