合并心血管疾病的食管癌老年患者的外科治疗分析

为了解心血管合并症对老年人食管癌手术治疗的影响和分析术后心血管并发症发生的原因。对９１例合并有心血管疾病的老年人食管癌外科治疗的临床资料进行回顾性分析。术后并发症发生率４８．４％（４４／９１），其中心血管合并症发生率３０．８％（２８／９１），手术死亡率２．２％（２／９１），５ａ生存率２９．３％。可以认为高龄和术前心血管合并症是老年人食管癌术后发生心血管并发症的基础，手术的应激反应、术后低氧血症、术前合并的慢性肺部疾病，在术后心血管并发症的发生中起着重要作用。重视围手术期处理和加强术后监护是降低老年人食管癌术后死亡率的重要措施。

Surgical Treatment of Senile Patients with Esophageal Carcinoma Combining with Angiocardiopathy

To evaluate the affection of preoperative combining with cardiovascular diseases to surgical treatment of the senile patients with esophageal carcinoma,and analyze the causes of postoperative cardiovascular complications,The clinical information on 91 cases of senile esophageal carcinoma combining with angiocardiopathy received surgical treatment from Jan.1989 to Jan.1997 was analyzed retrospecively.The total rate of postoperative complications was 48.4%(44/91). The cardiovascular complication rate was 30.8%(28/91).The operative mortality rate was 2.2%(2/91).The 5 year survival rate was 29.3%.Senility and preoperative combining with cardiovascular disease were the base of postoperative cardiovascular complications in the senile patients with esophageal carcinoma.As to stress to operation,postoperative hypoxemia and preoperative combining chronic pulmonary diseaese that all played important roles in causing the postoperative cardiovascular complicationas.Attaching importance to perioperative management and enforcing postoperative monitor were important measures to decrease the operative mortality of senile patients with esophageal carcinoma.