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目的探讨老年食管癌、贲门癌患者围手术期处理经验临床资料。方法对老年食管癌、贲门癌230例根治术进行回顾分析,平均年龄67岁(60~81岁)。围手术期予营养支持、戒烟、防治感染、严密监管、合并症的治疗、心血管评估及管理、呼吸道管理、并及时处理呼吸衰竭等并发症等。结果术后发生并发症70例,其中呼吸道并发症53例(75.71%),死亡5例,3例死于呼吸衰竭,1例死于吻合口楼并感染性休克,1例心脏猝死。随访131例,平均3.8(1~6)年,5年生存率分别为39.5%。结论老年食管癌、贲门癌围手术期予营养支持、术前术后严格的呼吸道管理等是手术成功的关键。
Objective To investigate the clinical experience of perioperative management of elderly patients with esophageal cancer and cardiac cancer. Methods 230 cases of esophageal cancer and cardia cancer were retrospectively analyzed. The average age was 67 years old (60-81 years old). Perioperative nutritional support, smoking cessation, infection control, close supervision, the treatment of complications, cardiovascular assessment and management, respiratory management, and timely treatment of respiratory failure and other complications. Results Postoperative complications occurred in 70 cases, including respiratory complications in 53 cases (75.71%), death in 5 cases, 3 died of respiratory failure, 1 died of anastomotic floor and septic shock, and 1 case of sudden cardiac death. Follow-up 131 cases, an average of 3.8 (1 ~ 6) years, 5-year survival rates were 39.5%. Conclusions Perioperative nutrition support for esophageal cancer and cardia cancer and strict management of respiratory tract before surgery are the keys to successful operation.