快速康复外科在大于60岁老年胃癌患者中的适用性分析

摘要

目的：探讨快速康复外科（fast track surger，FTS）在青年与老年胃癌患者中的安全性。方法：回顾性分析我院2009年1月至2013年9月采用快速康复策略的胃癌患者，分析比较青年与老年患者术后康复过程以及术后并发症出现的差异。结果：两组患者在年龄与合并疾病以及麻醉评分上具有明显差异性（ P ＜0.05），其他一般资料均无明显差异性（P ＞0.05）。术后康复过程中首次排气、排便与进食时间、术后尿管的拔出时间、抗生素使用时间、术后住院时间以及患者住院花费老年组略高于青年组，但两组之间的差异性无统计学意义（P ＞0.05）。老年组与青年组在术后并发症包括吻合口漏、肺炎、切口感染、泌尿系感染、深静脉血栓形成、肠梗阻的发生上并无明显差异性（P ＞0.05）；而老年组再次入院率较青年组较高，差异具有统计学意义（P ＜0.05）。结论：与青年胃癌患者相比，年龄≥60岁的老年胃癌患者在快速康复策略实施过程中具有相同的安全性与有效性。%Objective:To study the safety of elderly gastric cancer patients treated by fast track surger(FTS). Methods:The clinical data of patients with gastric cancer in FTS were analyzed retrospectively. The postoperative re-habilitation process and the difference of postoperative complications were compared. Results:There were no differ-ence in characteristics of patients except age,complication disease and ASA score. There were also no difference in clinical outcomes of patients include flatus,defecation,feed,urinary catheter removal,antibiotics postoperative stay and cost of hospitalization(P > 0. 05). The comparison results of anastomotic leakage,pneumonia,incision infection, urinary infection,deep - vein thrombosis,ileus and reoperation showed no difference but readmission of two groups have obvious difference(P < 0. 05). Conclusion:60 years or elder patients with gastric cancer in the implementation of FTS have the same safety and effectiveness with young patients of gastric cancer.