年龄及术前合并症对肝癌切除患者术后并发症的影响

摘要

目的:探讨高龄肝癌患者年龄及术前合并症等因素对术后并发症的影响.方法:回顾性分析2012年1月至2014年1月行肝脏部分切除术治疗的160例肝原发性恶性肿瘤患者(老年肝癌患者63例,非老年肝癌患者97例)的资料,分析年龄及术前合并症与术后并发症之间的关系.结果:高龄组术前高血压、心脏病、肺部疾病及多种合并症与对照组比较明显增高(P<0.05);高龄肝癌组伴有2种及以上合并症的患者29例,其中有21(72.4％)例患者出现了术后并发症,与其总体并发症发生率(28例,44.4％)比较差异有统计学意义(P=0.012).非老年肝癌组中,47例伴有合并症的患者中,有15例(31.9％)出现了术后并发症,与高龄肝癌组的总体发生率比较差异无统计学意义(P=0.183).在伴有高血压、心脏疾病、糖尿病和肺部疾病这4种术前合并症方面,有术后并发症的高龄组与无术后并发症的高龄组相比,差异有统计学意义(P<0.05).结论:年龄不是老年肝癌患者术后并发症的独立因素,高血压、糖尿病、肺部疾病、心脏疾病等术前合并症是老年肝癌患者术后发生并发症的高危因素.%Objective:To explore the influence of age and preoperative complications on occurrence of postopera-tive complications in elderly patients with hepatocellular carcinoma. Methods:The clinical data of 160 patients with hepatocellular carcinoma who had undergone liver resection in our department from January 2012 to January 2014 were retrospcetively analysed. Among them,63 patients were over 70 years old,and 97 patients were under 70 years old. The relationship between age,preoperative complications and postoperative complications was analyzed. Results:Complications including hypertension,heart disease,lung disease and so on were significantly higher in patients of eld-erly group than in non-elderly group (P < 0. 05). In 29 cases with more than 2 kinds of complications in elderly group,21 (72. 4％)suffered from postoperative complications,showing a significant difference (P = 0. 012)com-pared with the overall incidence of postoperative complications in elderly group (28 / 63,44. 4％). In 47 patients with preoperative complications in non-elderly group,15 (31. 9％)suffered from postoperative complications,but no sig-nificant difference (P = 0. 183)was found when compared with that of postoperative complications in elderly group. In elderly patients,the incidence of preoperative complications (hypertension,diabetes,lung disease,heart disease)was significantly different between those with postoperative complications and those without postoperative complications (P< 0. 05). Conclusion:Age is not the independent risk factor for occurrence of postoperative complications,while some preoperative complications (such as hypertension,diabetes mellitus,lung disease,heart disease)are the risk factors related to postoperative complications.