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目的分析食管癌患者术后1年内非肿瘤原因死亡的原因,以提高外科治疗效果。方法回顾性分析1997年10月至2002年10月甘肃省肿瘤医院收治的40例食管癌手术后1年内因非肿瘤原因死亡患者的临床资料,其中男35例,女5例;年龄53~76岁(65±13岁)。对40例食管癌手术后死亡患者进行随访,并分析其死亡的原因。结果 40例非肿瘤复发转移死亡中有27例(67.50%)行食管癌根治手术,22例(55.00%)无淋巴结转移,38例(95.00%)切缘癌阴性。术后因放化疗并发症死亡11例,主要原因是化疗引起肝、肾功能衰竭、消化道和呼吸道大出血、全身衰竭;放疗致食管主动脉瘘、食管气管瘘、食管胸膜瘘等。因手术相关并发症死亡18例,主要原因是脓胸胸腔感染、切口感染、坏疽性肠梗阻、胃功能障碍、胸胃扩张无法进食致全身衰竭、反流性食管溃疡致上消化道出血和误吸致肺部感染等。因老年合并疾病死亡11例,主要原因是心肌梗死、肺栓塞和脑出血等。结论对食管癌患者应重视食管癌术后放化疗并发症的预防,重视出院后远期并发症、老年病的预防和治疗,加强多科的康复治疗。
Objective To analyze the causes of non-tumor causes of death in patients with esophageal cancer within 1 year after surgery to improve the effect of surgical treatment. Methods The clinical data of 40 patients with esophageal cancer who died from non-tumor within one year after surgery in Gansu Provincial Cancer Hospital from October 1997 to October 2002 were retrospectively analyzed, including 35 males and 5 females, aged 53-76 Years old (65 ± 13 years old). Forty patients with esophageal cancer who died after surgery were followed up and the causes of death were analyzed. Results Of the 40 cases of non-tumor recurrence and metastasis death, 27 cases (67.50%) underwent radical resection of esophageal cancer, 22 cases (55.00%) had no lymph node metastasis and 38 cases (95.00%) had negative margin cancer. Postoperative radiotherapy and chemotherapy due to complications of death in 11 cases, mainly due to chemotherapy-induced liver and kidney failure, gastrointestinal and respiratory tract hemorrhage, systemic failure; radiotherapy induced esophageal aortic fistula, esophageal tracheal fistula, esophageal pleural fistula. Eighteen patients died of complications related to surgery, mainly due to empyema thoracic infection, incisional infection, gangrenous intestinal obstruction, gastric dysfunction, failure to eat in the chest and stomach caused by systemic failure, and reflux of esophageal ulcer caused by upper gastrointestinal bleeding and mistakes Absorption of lung infections. 11 cases of death due to senile combined disease, mainly due to myocardial infarction, pulmonary embolism and cerebral hemorrhage. Conclusion Patients with esophageal cancer should pay more attention to the prevention of postoperative radiotherapy and chemotherapy complications of esophageal cancer, pay attention to the prevention and treatment of long-term complications and geriatric diseases after discharge, and strengthen the multi-disciplinary rehabilitation.