文档介绍：30例高龄直肠癌患者的外科治疗
(作者:___________单位: ___________邮编: ___________)
【摘要】目的:探讨高龄直肠癌患者行手术治疗的可行性。方法:回顾分析自1990年1月至2007年1月收治的30例高龄直肠癌患者的外科资料。结果:30例患者全部经手术治疗,1例出现大面积脑梗死,1例出现呼吸衰竭,其余均获得较为满意的效果。结论:高龄直肠癌患者并发症多,手术风险大,行姑息性直肠癌切除不失为一种明智的选择。
【关键词】直肠癌;高龄患者
Abstract Objective: To explore the feasibility of surgery in elderly patients with rectal cancer. Methods: The experience of surgical management for 30 elderly rectal cancer patients was analyzed retrospectively from January 1990 to January 2007. Result: Among 30 elderly patients with surgery, 28 patients had satisfactory effect except for 2 cases (One case got cerebral infarction of large area, another died because of respiratory failure). Conclusion: It is judicious choice to cut the tumor with palliation
because the elderly rectal cancer patients have more coexisting diseases and more surgical risk.
Key words Rectal cancer; Elderly; Patient
随着人们生活水平的提高、人均寿命延长、人口老龄化,高龄患者也渐增多,高龄直肠癌患者日益常见。由于高龄直肠癌患者症状不典型,体质弱,伴发病多等特点,常给外科治疗带来很多困难[1]。我院于1990年1月至2007年1月给予30例老年低位直肠癌伴多种严重并发症的患者行经会阴直肠癌姑息性切除术,获得较为满意的效果,现分析及总结如下。
1 临床资料
一般资料选取经病理检查确诊的30例直肠腺癌患者,男20例,女10例,年龄75~89岁,;其中11例直肠癌伴急性肠梗阻,3例直肠癌伴肝转移,7例直肠癌伴肺气肿、肺心病(其中2例Ⅰ型呼衰),3例直肠癌伴肾功能不全,3例直肠癌伴脑梗塞(2例为多发性腔隙性梗塞、1例大面积梗塞),3例直肠癌伴心律失常(2例为房颤、1例频发室性早搏)。经会阴直肠癌切除术适应证:老年体弱患者;低位直肠癌(肿瘤距肛缘<5cm);伴发一种或多种较严重的并发症;肿瘤长度一般小于10cm;伴有远处转移。
术前准备肠梗阻的患者给予持续胃肠减压、抗炎、纠正水电解质紊乱治疗;肺气肿、肺心病的患者给予持续低流量吸氧、肺功能煅炼;肝转移患者术前给予介入