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目的探讨老年胃癌患者手术治疗后并发症发生率及影响预后的因素。方法抽取2008年3月-2011年3月在新疆医科大学第一附属医院胃肠肿瘤外科手术治疗的老年胃癌患者115例,观察患者术前一般指标、手术相关指标、病理指标、术后随访预后结果。采用Kaplan-Meier生存分析、Log-rank趋势检验进行生存预后分析,应用Logistic回归方法对并发症的影响因素进行多因素相关分析。结果老年胃癌患者术后并发症的发生与手术时间、清扫淋巴结个数、性别、民族、术前合并症、手术方式有关,差异有统计学意义(P<0.05)。无并发症患者生存率明显高于有并发症患者(P<0.05)。Logistic回归分析发现老年胃癌患者术后并发症发生与手术时间、清扫淋巴结个数、术前合并症和民族有关(P<0.05)。结论提高技术熟练度,以降低在老年胃癌患者执行手术所耗时间、结合病理报告减少清扫的淋巴结个数,对于术前有合并症及少数民族患者,需加强术后并发症的预防措施,从而降低术后并发病发生率,提高患者存活率。
Objective To investigate the incidence of postoperative complications and prognosis in elderly patients with gastric cancer. Methods From March 2008 to March 2011, 115 cases of elderly patients with gastric cancer underwent surgical treatment of gastrointestinal tumors at the First Affiliated Hospital of Xinjiang Medical University. The general indexes, operative indexes, pathological indexes, postoperative follow-up prognosis result. Survival analysis was performed by Kaplan-Meier survival analysis and Log-rank trend test. Logistic regression was used to analyze the influencing factors of complications. Results The incidence of postoperative complications in elderly patients with gastric cancer was significantly related to the time of operation, the number of lymph nodes dissected, gender, ethnicity, preoperative complications and surgical modality. The difference was statistically significant (P <0.05). The survival rate of non-complication patients was significantly higher than that of patients with complications (P <0.05). Logistic regression analysis showed that the incidence of postoperative complications in elderly patients with gastric cancer was related to the time of operation, the number of lymph nodes dissected, preoperative complications and ethnic groups (P <0.05). Conclusion To improve the technical proficiency to reduce the time spent in performing surgery in elderly patients with gastric cancer and to reduce the number of dissected lymph nodes combined with pathological reports. Preoperative complications and ethnic minority patients need to strengthen the prevention of postoperative complications, thus Reduce the incidence of postoperative complications and improve patient survival.