老年结直肠癌患者的围手术期处理分析

目的　探讨老年结直肠癌患者的围手术期处理。方法　回顾性分析我院 1989～1999年间 186例 60岁以上结直肠癌患者外科处理的临床资料。结果　术前误诊 10 2例 ,有并存病15 2例。行根治性切除 12 9例 ,姑息性切除 14例 ,Hartmann术 15例。结肠造口 2 8例 ,术后出现并发症 5 2例 ,围手术期死亡 3例。 1、2、3年生存率分别为 89.8%、69.4%、61.3 %。结论　老年结直肠癌患者最好的治疗方法仍是手术切除。但早期诊断、合理的手术时机与手术方式、合理处理并存病 ,充分的术前准备和完善的麻醉 ,是减少并发症提高疗效的关键。

Perioperative treatment of the elderly patients with colorectal carcinoma (report of 186 cases)

Objective To explore the perioperative management of the elderly patients with colorectal carcinoma.Method The clinical data of surgical treatment for colorectal carcinoma in 186 cases of over 60 years old from 1989 to 1999 were analyzed retrospectively.Results Preoperative misdiagnosis occurred in 102 cases;152 cases had accompanied diseases.129 cases were subjected to radical surgery,14 to palliative resection,15 to Hartmann operation,28 to colostomy.Postoperative complications occurred in 52 cases.There cases were perioperative dead.1,2,3-year survival rate was 89.8%,69.4% and 61.3% respectively.Conclusion Operative resection is an ideal way to treat the elderly patients with colorectal carcinoma.But early diagnosis,proper management of accompanied diseases,full bowel preparation, appropriate choice of anesthesia and operation time and surgical procedures are critical to reduce complications and enhance the curative effect.