| 陈安 杨振宇 殷祥烨 刘尧 杜锡林.高龄肝癌患者肝癌切除术后并发症及预后分析[J].,2016,16(28):5464-5467 |
| 高龄肝癌患者肝癌切除术后并发症及预后分析 |
| Analysis of Complications and Outcomes after Hepatic Resection in Aged Patients |
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| DOI： |
| 中文关键词: 高龄 原发性肝癌 肝切除术 预后因素 |
| 英文关键词: Age PLC Resection surgery Prognosis |
| 基金项目:国家自然科学基金项目（81172287） |
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| 中文摘要: |
| 目的：探讨高龄原发性肝癌患者肝癌根治性切除术的疗效及安全性。方法：回顾性分析63 例(高龄组≥ 70 岁)与98 例(对照
组<70 岁)行肝部分切除术的原发性肝癌患者的一般资料及其围手术期情况，对其术后并发症及预后进行探讨。结果：高龄组术后
并发症发生率为36.5%，对照组31.6%(P>0.05)，高龄组7(11.1%)例肝衰竭，2(3.17%)例术后有出血现象，3(4.8%)例切口感染，3
(4.8%)例胸腔积液，1(1.5%)例伴有隔下感染，1(1.5%)例有严重肺部感染,由于下肢深静脉血栓脱落，死于急性肺动脉栓塞。组织病
理类型高龄组以结节型多见，Edmondson I-II级33 例，III-IV 级18 例，胆管细胞癌8 例，混合细胞型4 例。BCLC-0、A、B、C 期分别
占2、9、35、17 例。高龄组与对照组1、2、3 年生存率分别为82.5%VS85.7%、34.9%VS46.3%、15.9%VS36.8%。结论：高龄对肝部分
切除术后并发症的发生并无明显影响，并不是原发性肝癌根治性手术切除术的禁忌症，高龄患者2、3 年生存率较对照组低。 |
| 英文摘要: |
| Objective:To explore the therapeutic effect and degree of safety in aged patients with primary carcinoma of the liver
undergoing radical resection.Methods:The clinical records of 63 patients (older group≥ 70years) and 98 patients (younger group<70
years) with PLC undergoing resection surgery analyzed retrospectively, and the follow-up of these patients was performed, we
investigated and discussed the postoperative complications and?the clinical features or prognoses of these people.Results:The
post-operative complications (POC) occurred in 23 of older group(36.5%) versus 31 in younger group(31.6%)(P>0.05)，POC occurred in
older group of 7 (11.1%) cases of liver failure, 2 (3.17%) cases of postoperative bleeding，3 (4.8%) cases incision infection, 3(4.8%) cases
of pleural effusion,1 (1.5%) cases of sub-phrenic infection,1 (1.5%)case with severe pulmonary infection. Only one patient died to the
acute pulmonary embolism. The histopathology diagnosis showed there were nodes and giant mass type in aged patients, and Edmondson
I-II in 33 patients, III-IV in 18, cholangiocarcinoma in 8, Mixed cellularity in 4. The cases of BCLC 0, A, B, C phase respectively has 2,
9, 35, 17. The survival rate of older group verses younger group was 82.5%vs85.7%, 34.9%vs46.3%/15.9%vs36.8% at 1, 2 and 3 years,
respectively.Conclusion:Advanced age has no obvious effect on the occurrence of POC after hepatectomy and is not a contraindication
to radical hepatic resection in patients over 70 years old suffering from early primary liver carcinoma, however, older group patients has
lower survival rate than younger group patients in 2 and 3 year. |
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