76例高龄食管中下段癌、贲门癌合并糖尿病手术治疗的临床研究

目的探讨76例高龄食管中下段癌、贲门癌合并糖尿病手术治疗的临床效果。方法选择2008年2月~2010年10月在我院接受手术治疗的高龄食管中下段癌、贲门癌合并2型糖尿病患者的临床资料进行分析,总结临床手术治疗经验及相关注意事项。结果在经过积极的手术治疗及合并症防治后,无吻合口瘘、脓胸、乳糜胸等并发症。76例患者随访3年,其中1、2、3年生存率分别为98.68%、92.11%和86.84%。手术后患者在QLICP-ES生活质量评分各领域均明显较手术前改善,且差异有统计学意义(P<0.05)。结论食管中下段癌、贵门癌合并糖尿病,增加了外科手术后并发症的发生率和病死率,一方面严格控制血糖,另外一方面针对高龄患者的身体特点给予针对性的处理措施,可以达到理想的外科治疗效果。

Clinical study of surgical treatment for 76 cases of the middle and lower esophageal cancer,cardia cancer complicated with diabetes

Objective To investigate the clinical effect of surgical treatment for 76 cases middle and lower esophageal cancer, cardia cancer complicated with diabetes. Methods From February 2008 to October 2010, this study selected elderly patients with the middle and lower esophageal cancer, cardia cancer received operation therapy in our hospital complicated with type 2 diabetes were analyzed. This study summarized the experience of clinical operation treatment and related matters needing attention. Results After active treatment and prevention of complications, all patients were safe during peri operation period, and there were no Anastomotic fistula, empyema and chylothorax complication. The 1, 2, 3 year survival rate were 98.68%,92.11% and 86.84%. QLICP-ES score of quality of life in all areas significantly improved after operation, and the difference had statistically significant （P 〈 0.05）. Conclusion The surgical operation complications and mortality rate increased in elderly patients with the middle and lower esophageal cancer, cardia cancer complicated with diabetes. On one hand, we should control the blood glucose strictly, on the other hand we should give the corresponding treatment measures according to the physical characteristics of elderly patients. Ideal surgery treatment effect can be achieved.