摘要
目的 探讨老年喉癌病人的围手术期最佳处理方案，以减少术中、术后并发症，使手术风险降至最低。方法 对我科1980年1月－2000年6月间收治的喉癌手术病人936例进行年龄分布（80年代与90年代≥60岁喉癌病人所占住院病人比例）、术前所患慢性疾病、术后并发症等的分析比较（设≥60岁与≤59岁两组）。结果 ①80年代≥60岁的老年病人占27．50％（110／400），而90年代为43．28％（232／536），二者间差异有显著性意义。②≥60岁者（148例）与≤59岁（148）的两组病人术前所患慢性疾病及术后并发症比较结果：前者患慢性病者占75．67%(112/148),徨者为52．70％（78／148）二者差异有显著性意义（P＜0．01），术后并发症比较：60岁以上病人组为25．67％（38／148），59岁以下病人组是16．21％（24／148），两组间差异有显著性意义（P＜0．05），≥60岁组死亡3例。结论 老年人机体趋于衰老，各脏器、组织乃至细胞均在发生退行性变，功能减退，易患多种疾病，因而对手术的应激能力下降，术后易出现并发症。为减少并发症，使手术风险降至最低，应做到：术前详细了解病史，严格体格检查，发现问题及时与有关专家共同诊治，使身体状况达最佳状态；根据病人具体情况选择适当的术式与麻醉；术后除严密观察术区情况及有无并发症外；应注意营养状态；保持水电解质、酸碱平衡。
ve To investigate the most appropriate program of peri-operative treatment for senile patient with laryngeal carcinoma. Methods A retrospective study was carried out on 936 cases with laryngeal carcinoma treated by total or partial laryngectomy from 1980 to 2000, in order to find out the correlation of age distribution of the patients and the present of chronic diseases suffered before operation with the incidence of surgical complications after operation respectively. It was based on the grouping to 1980s and 1990s, or on the grouping to patients aged ≥60 and aged <60. ResultsThere was a significant difference in the distribution of older cases≥60 between 1980s and 1990s(P<0. 01),27. 50% in 80s and 41. 42% in 90s respectively, a significant difference (P<0. 01)in the incidence of chronic diseases suffered before operation between the older group (≥60) and the younger group (<60),75. 67% for the older group and 52. 70% for the younger group, and a significant difference in the incidence distribution of surgical complications after operation between the two different age groups, being 25. 69% for the older and 16. 21% for the younger (P<0. 05) ConclusionSenile patients are very susceptible to surgical complications because of degeneration and dysfunction of organs, tissuse and cells in the whole body of them, as well as the higher incidence of chronic diseases among them, leading to a decreased situation of toleration to operation. To reduce the risk of surgical complications, it is very important to review carefully medical history, to do physical examination thoroughly before operation to give an appropriate treatment to make the patient recovering to a best situation, and to make a good discussion with the specialists of other departments for selection of surgical procedure and anesthesia technique.
出处
《中国中西医结合耳鼻咽喉科杂志》
2002年第3期125-128,共4页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
关键词
老年病人
喉癌
围手术期
处理
Senile patients Larygeal carcinoma Peri-operative treatment
