老年病人胃癌术后呼吸道并发症的防治

目的探讨65岁以上老年胃癌病人胃癌术后呼吸道并发症的原因及预防治疗。方法回顾性分析1996年1月至2005年12月间我院行65岁以上胃癌切除术病人的临床资料。结果研究期间65岁以上老年胃癌病人行胃癌切除术共95例,术前合并呼吸道疾病者26例;术后并发急性气管支气管炎、肺炎、肺不张等共25例,术前有无呼吸道伴发病者分别为12例(46.2%),13例(18.8%),统计学差异有显著性意义。手术死亡1例,因胸腔积液和肺部感染死于呼吸功能衰竭。结论65岁以上合并有呼吸道疾病者胃癌术后急性气管支气管炎、肺部感染和肺不张发生率高,手术前后的呼吸道疾病的发生将增加手术风险,应重视围术期处理。

Respiratory tract complication in older patients after gastrectomy for gastric cancer

Objective: To investigate the cause, prevention and treatment of postoperative complication of respiratory system in patients over 65 years underwent gastrectomy for gastric cancer. Methods: From January 1996 to December 2005 the clinical data of patients older than 65 and underwent gastrectomy for carcinoma of the stomach in our hospital were analyzed retrospectively. Results: Of 95 patients over 65 years underwent gastrectomy for gastric cancer, 26 were with preoperative respiratory tract disease, 25with acute tracheobronchitis,pulmonary infection and atelectasis , and 8 with abdominal complications. Of 25 acute tracheobronchitis ,pulmonary infection and atelectasis ,12(46.2%) and 13(18.8%), respectively, were recorded in patients with or without coexistent respiratory tract disease, 2 of the abdominal complications (wound dehiscence) related to respiratory disease, 1 patients died of respiratory complication postoperatively. Conclusion: The postoperative morbidity of pulmonary tract in elderly patients underwent gastrectomy for cancer of the stomach is higher in patients with preoperative respiratory system disease then those withont this disease . The preoperative or postoperative respiratory system disease increase postoperative abdominal incision complication and operation risk .The perioperative management is important for patients with preoperative or postoperative disease of respiratory system.