55例老年胃癌患者发生术后并发症临床分析.docVIP

55例老年胃癌患者发生术后并发症临床分析 　　[摘要] 目的 ??老年胃癌手术患者术后并发症发生情况以及影响其发生的相关因素进行分析。方法 方便选取福建省肿瘤医院2011年3月―2012年3月期间55例老年胃癌手术患者（≥70岁）的临床病理资料进行回顾性分析，采用logistic回归分析影响术后并发症发生的相关因素，根据Kaplan-Meier法分析术后的5年生存率。结果 全组55例老年患者中，17例发生并发症，发生率为30.9%。其中肺部感染7例，吻合口瘘5例，腹腔感染3例，肠梗阻2例。单因素分析显示，并发症组与无并发症组在是否有吸烟史、术中出血量、手术时间、体质数、术前呼吸功能不全、肺部疾病等因素的比较差异有统计学意义（P0.05）。logistic多因素分析显示，吸烟史、术中出血量、手术时间、术前呼吸功能不全、体质数、肺部疾病均是影响患者疾病发生的独立因素。并发症组患者的5年生存率为58.8%，无并发症组患者的5年生存率为75.0%，差异有统计学意义（χ2=4.37，P0.05）。 结论 老年胃癌患者术后发生并发症率较高，吸烟史、术中出血量、手术时间、术前呼吸功能不全、体质数、肺部疾病均是影响患者术后并发症发生的独立因素。 　　[关键词] 老年胃癌；术后并发症；影响因素 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）12（c）-0055-03 　　[Abstract] Objective This paper tries to analyze the incidence of postoperative complications and related factors in elderly patients with gastric cancer surgery. Methods The clinical and pathological data of 55 cases of elderly patients with gastric cancer （over 70 years old） from March 2011 to March 2012 in this hospital were convenient selected retrospectively analyzed. Logistic regression was used to analyze the related factors of postoperative complications， according to the analysis of the 5 year survival rate after operation by Kaplan-Meier. Results Among the 55 elderly patients， 17 cases had complications， with the incidence rate of 30.9%. There were 7 cases of pulmonary infection， 5 cases of anastomotic leakage， 3 cases of abdominal infection， and 2 cases of intestinal obstruction. Univariate analysis showed that there was significant difference between the complication group and the non complication group in the history of smoking， the amount of bleeding during operation， the time of operation， the number of physical fitness， preoperative respiratory insufficiency， lung disease and other factors（P0.05）. Logistic multivariate analysis showed that smoking history， intraoperative blood loss， operation time， preoperative respiratory insufficiency， physical fitness， lung disease were independent factors affecting the patient’s disease. The 5 year survival rate