老年胃癌患者術后嚴重并發癥的相關因素分析_《中國普外基礎與臨床雜志》

作者：

周立宇 , 孫立波 , 李永超 , 丁大勇 , 舒振波 , 鄭澤霖

吉林大學中日聯誼醫院胃腸外科(吉林長春130033);

關鍵詞：

老年胃癌術后并發癥

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目的探討影響老年胃癌患者術后嚴重并發癥的主要因素。方法回顧性分析2003年1月至2008年12月期間在吉林大學中日聯誼醫院接受手術治療的老年胃癌患者202例，以術后是否發生并發癥及嚴重程度分為有和無嚴重并發癥組，分別從臨床因素和實驗室檢查兩方面分析老年胃癌患者術后出現嚴重并發癥的相關因素。結果在臨床指標中，術前有并存癥、行全胃切除、術中出血量≥800 ml、術中輸血量以及聯合臟器切除與手術后嚴重并發癥相關(P lt;0.05)。實驗室檢查指標中，術前血清白蛋白值及術后第1天血糖值與手術后嚴重并發癥相關(P lt;0.05)。結論術前有并存疾病、低蛋白血癥以及擴大根治手術是老年胃癌患者術后出現嚴重并發癥的危險因素。

引用本文： 周立宇,孫立波,李永超,丁大勇,舒振波,鄭澤霖. 老年胃癌患者術后嚴重并發癥的相關因素分析. 中國普外基礎與臨床雜志, 2011, 18(6): 639-642. doi: 復制

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19.	Chen G, Zhang FJ, Gong M, et al. Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients [J]. J Zhejiang Univ Sci B, 2007, 8(8): 560565.
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21.	Shen JG, Cheong JH, Hyung WJ, et al. Pretreatment anemia is associated with poorer survival in patients with stage Ⅰ and Ⅱ gastric cancer [J]. J Surg Oncol, 2005, 91(2): 126130.
22.	Otsuji E, Fujiyama J, Takagi T, et al. Results of total gastrectomy with extended lymphadenectomy for gastric cancer in elderly patients [J]. J Surg Oncol, 2005, 91(4): 232236.
23.	Kodera Y, Sasako M, Yamamoto S, et al; Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Identification of risk factors for the development of complications following extended and superextended lymphadenectomies for gastric cancer [J]. Br J Surg, 2005, 92(9): 11031109.
24.	Tsujinaka T, Sasako M, Yamamoto S, et al; Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Influence of overweight on surgical complications for gastric cancer: results from a randomized control trial comparing D2 and extended paraaortic D3 lymphadenectomy (JCOG9501) [J]. Ann Surg Oncol, 2007, 14(2): 355361.
25.	周巖冰, 張堅, 李世寬, 等. 胃癌術后并發癥多因素Logistic回歸分析及風險模型的建立 [J]. 中華普通外科雜志, 2007, 22(3): 164167.

1. Finlayson EV, Birkmeyer JD. Operative mortality with elective surgery in older adults [J]. Eff Clin Pract, 2001, 4(4): 172177.
2. So JB, Yam A, Cheah WK, et al. Risk factors related to operative mortality and morbidity in patients undergoing emergency gastrectomy [J]. Br J Surg, 2000, 87(12): 17021707.
3. Whiteley MS, Prytherch DR, Higgins B, et al. An evaluation of the POSSUM surgical scoring system [J]. Br J Surg, 1996, 83(6): 812815.
4. Hariharan S, Zbar A. Risk scoring in perioperative and surgical intensive care patients: a review [J]. Curr Surg, 2006, 63(3): 226236.
5. Neary WD, Heather BP, Earnshaw JJ. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) [J]. Br J Surg, 2003, 90(2): 157165.
6. Sah BK, Zhu ZG, Chen MM, et al. Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment [J]. Langenbecks Arch Surg, 2009, 394(1): 4147.
7. Tonouchi H, Ohmori Y, Tanaka K, et al. Fatal and nonfatal complications after surgical resection for gastric cancer [J]. Hepatogastroenterology, 2006, 53(67): 145149.
8. 樊濤, 戴冬秋, 徐惠錦, 等. 老年胃癌患者并存疾病的圍手術期處理 [J]. 中國普外基礎與臨床雜志, 2009, 16(12): 10171024.
9. Bozzetti F, Gianotti L, Braga M, et al. Postoperative complications in gastrointestinal cancer patients: the joint role of the nutritional status and the nutritional support [J]. Clin Nutr, 2007, 26(6): 698709.
10. 魯修明, 孫立波, 李永超, 等. 70歲以上老年胃癌患者術后早期停止胃腸減壓恢復腸內營養的臨床觀察 [J]. 中國普外基礎與臨床雜志, 2009,10(1): 87.
11. Sungurtekin H, Sungurtekin U, Balci C, et al. The influence of nutritional status on complications after major intraabdominal surgery [J]. J Am Coll Nutr, 2004, 23(3): 227232.
12. Yasuda K, Shiraishi N, Adachi Y, et al. Risk factors for complications following resection of large gastric cancer [J]. Br J Surg, 2001, 88(6): 873877.
13. Kunisaki C, Shimada H, Ono H, et al. Predictive factors for pancreatic fistula after pancreaticosplenectomy for advanced gastric cancer in the upper third of the stomach [J]. J Gastrointest Surg, 2006, 10(1): 132137.
14. 何裕隆. 胃癌根治術中聯合胰腺、脾臟切除的問題 [J]. 外科理論與實踐, 2008, 13(1): 911.
15. AWeitz J, Jaques DP, Brennan M, et al. ssociation of splenectomy with postoperative complications in patients with proximal gastric and gastroesophageal junction cancer [J]. Ann Surg Oncol, 2004, 11(7): 682689.
16. 崔超, 孫立波, 舒振波, 等. 進展期近端胃癌根治術聯合脾臟切除術適應證的選擇 [J]. 中國普外基礎與臨床雜志, 2010, 17(1): 2224.
17. Hyung WJ, Noh SH, Shin DW, et al. Adverse effects of perioperative transfusion on patients with stage Ⅲ and Ⅳ gastric cancer [J]. Ann Surg Oncol, 2002, 9(1): 512.
18. Bellantone R, SitgesSerra A, Bossola M, et al. Transfusion timing and postoperative septic complications after gastric cancer surgery: a retrospective study of 179 consecutive patients [J]. Arch Surg, 1998, 133(9): 988992.
19. Chen G, Zhang FJ, Gong M, et al. Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients [J]. J Zhejiang Univ Sci B, 2007, 8(8): 560565.
20. Marrelli D, Pedrazzani C, Neri A, et al. Complications after extended (D2) and superextended (D3) lymphadenectomy for gastric cancer: analysis of potential risk factors [J]. Ann Surg Oncol, 2007, 14(1): 2533.
21. Shen JG, Cheong JH, Hyung WJ, et al. Pretreatment anemia is associated with poorer survival in patients with stage Ⅰ and Ⅱ gastric cancer [J]. J Surg Oncol, 2005, 91(2): 126130.
22. Otsuji E, Fujiyama J, Takagi T, et al. Results of total gastrectomy with extended lymphadenectomy for gastric cancer in elderly patients [J]. J Surg Oncol, 2005, 91(4): 232236.
23. Kodera Y, Sasako M, Yamamoto S, et al; Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Identification of risk factors for the development of complications following extended and superextended lymphadenectomies for gastric cancer [J]. Br J Surg, 2005, 92(9): 11031109.
24. Tsujinaka T, Sasako M, Yamamoto S, et al; Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Influence of overweight on surgical complications for gastric cancer: results from a randomized control trial comparing D2 and extended paraaortic D3 lymphadenectomy (JCOG9501) [J]. Ann Surg Oncol, 2007, 14(2): 355361.
25. 周巖冰, 張堅, 李世寬, 等. 胃癌術后并發癥多因素Logistic回歸分析及風險模型的建立 [J]. 中華普通外科雜志, 2007, 22(3): 164167.

《中國普外基礎與臨床雜志》

老年胃癌患者術后嚴重并發癥的相關因素分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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《中國普外基礎與臨床雜志》

老年胃癌患者術后嚴重并發癥的相關因素分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料