食管贲门癌高龄患者外科治疗的探讨

对高龄食管贲门癌患者手术指征的选择,不宜把病人年龄、心电图改变、肿癌大小作为绝对指征。决定病人可否手术是病人的“生理年龄”比实际年龄更为重要。凡肿瘤在一年以内,食管钡餐相小于10cm,软组织影不大,无远处淋巴转移,心脏代偿功能较好。在作好术前准备,如进行全面的体格检查及必要的辅助检查,了解各系统情况;矫正低蛋白、贫血、脱水及电解质紊乱,加强支持疗法,抗感染,且术中仔细操作,加强麻醉处理,心脏监护,确保血压平稳,避免使用对呼吸道剌激性大的药物等,这样均可使患者耐受手术。

Surgical Treatment of Aged Patients with Carcinoma of Esophagus and Cardia

The physiological age of the aged patient with carcinoma of esophagus and cardia is more important in deciding which patient should be operated on than actual age. The age,ECG changes and the size of the tumor should not be considered as absolute indications. The patients whose histories are 1 year or less and whose extent of pathological change in barrium-sweallowed examination is less than 10cm, without enlargement of soft tissue and distant metastasis. are able to endure and recover from operation if provided proper pre-operative management such as a thorougn systematic physical examination and other necessitated auxiliary examination, correcting hypoproteinemia,anemia, dehydration and electrolyte disturbances strengthening supportive and anti -infection treatments;careful handling in operation,and intensive care in anesthasia including ECG monitoring, ensuring the stabilization of blood pressure and avoiding irritation in the respiratory tract.