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70岁以上老年肺癌患者的手术治疗及围手术期处理
引用本文:马胡赛,蔡奕欣,张霓,付向宁.70岁以上老年肺癌患者的手术治疗及围手术期处理[J].临床外科杂志,2014(11):840-842.
作者姓名:马胡赛  蔡奕欣  张霓  付向宁
作者单位:1. 430030 武汉,华中科技大学同济医学院附属同济医院胸外科; 青海红十字医院胸外科
2. 华中科技大学同济医学院附属同济医院胸外科, 武汉,430030
摘    要:目的:探讨老年肺癌患者的手术方式及围手术期处理。方法回顾性分析79例老年非小细胞肺癌行手术治疗患者资料。其中胸腔镜肺叶切除术47例,常规开胸肺叶切除术32例。结果胸腔镜组及常规开胸组患者术中失血量和清扫淋巴结数差异无统计学意义(P >0.05);住院时间、术后心肺并发症发生率差异有统计学意义(P <0.05)。围手术期死亡7例,其余患者术后出现心脏、呼吸系统等并发症治疗后痊愈,均顺利出院。结论老年肺癌患者术后并发症发生率及死亡率高,围手术期处理十分重要;胸腔镜下肺叶切除术可取得良好的效果。

关 键 词:非小细胞肺癌  老年  围手术期  肺叶切除术

Surgical treatment and perioperative management for elderly lung cancer patients aged over 70 years
Institution:MA Hu-sai, CAI Yi-xin ,ZHANG Ni, et al. (Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China)
Abstract:Objective To explore the surgical treatment and perioperative management for elderly lung cancer patients.Methods The surgical data of 79 elderly non-small cell lung cancer(NSCLC)pa-tients were retrospectively reviewed,including 47 cases of thoracoscopic lobectomy and 32 cases of conven-tional lobectomy.Results There were no significant differences in intraoperative blood loss and dissected lymph node number between the thoracoscopy group and thoracotomy group(P 〉0.05).There were signifi-cant differences in hospital stay and incidence of postoperative cardiopulmonary complications between the groups(P 〈0.05).Except for 7 cases of perioperative death,the remaining patients with cardiac and re-spiratory complications were treated,recovered and discharged smoothly.Conclusion Perioperative man-agement is very important because the incidence of surgical complications and mortality in elderly patients with NSCLC is high.Thoracoscopic lobectomy for elderly patients with NSCLC can achieve good results.
Keywords:non-small cell lung cancer  elderly  perioperatire period  lobectomy
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