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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),后者为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
Objective To investigate the best perioperative management of elderly patients with laryngeal cancer to reduce intraoperative and postoperative complications and to minimize the surgical risk. Methods A total of 936 patients with laryngeal cancer admitted to our department between January 1980 and June 2000 were analyzed for age distribution (the proportion of inpatients with laryngeal cancer≥60 years old in the 1980s and 1990s), preoperative chronic diseases , Postoperative complications such as analysis and comparison (set ≥ 60 years old and ≤ 59 years old two groups). Results ① The elderly patients ≥60 years of age in the 1980s accounted for 27.50% (110/400) compared with 43.28% (232/536) in the 1990s, the difference was significant. ②Comparison of preoperative chronic diseases and postoperative complications between ≥60 years old (148 cases) and ≤59 years old (148) showed that the former accounted for 75.67% (112/148) of patients with chronic diseases and the latter Were 52.70% (78/148), there was significant difference between them (P <0.01) .Comparison of postoperative complications: 25.67% (38/148) and 59 years The following patient group was 16.21% (24/148), the difference between the two groups was significant (P <0.05), 3 patients died ≥ 60 years old. Conclusion The elderly tend to be aging, the organs, tissues and even cells are degenerative changes, hypofunction, susceptible to a variety of diseases, so the ability to stress surgery decreased postoperative complications. In order to reduce the complication and minimize the operation risk, we should do the following: preoperative detailed medical history, rigorous physical examination and timely diagnosis and treatment with relevant experts so that the best condition of the body can be found;