%0 Journal Article %T 老年肝门胆管癌的围手术期处理 %A 戚洪涛 %J 华西医学 %P 1436-1438 %D 2010 %X 【】目的探讨老年肝门胆管癌的围手术期处理方法。方法回顾性分析1992年6月-2004年10月收治的60岁以上的肝门胆管癌患者临床资料。结果78例患者合并有多脏器储备功能改变,施行手术切除12例,外引流手术11例,内引流手术55例。17例出现并发症,以肺部感染、肝肾功能衰竭和吻合口瘘为多见。根治性切除、姑息性切除和姑息性引流组手术后中位生存时间分别为12、8、5个月。结论肝门胆管癌的手术复杂,创伤大,对老年患者更容易产生心肺功能异常及各种并发症;但通过围手术期内合理、充分的综合治疗措施,仍能取得较好的治疗效果。?【Abstract】ObjectiveToinvestigatetheperioperativetherapyfortheelderpatientswithhilarcholangiocarcinoma.MethodsTheclinicaldataofover60yearsoldpatientswithhilarcholangiocarcinomawhoweretreatedinthehospitalfromJune1992toOctober2004wereretrospectivelyanalyzed.ResultSeventy-eightpatientswithmultipleorgansliverfunctionalchanges,12patientsreceivedsurgicalexcision,11patientsreceivedexternaldrainagesurgery,55patientsreceivedinternaldrainagesurgery.Postoperativecomplicationsoccurredin17patients,wostofwhichwerelunginfection,liverandkidneyfailureandanastomoticleakage.Themediansurvivaltimewere12,eightandfivemonthsforthepatientswhoreceivedradicalresection,palliativeresectionanddrainage,respectively.ConclusionsThesurgicaltreatmentforhilarcholangiocarcinomaiscomplicatedwithmajorsurgicaltrauma.Thepostoperativecomplicationandthecardio-pulmonarydysfunetionareeasilyhappenedespeciallyintheagedpatients.Intensivesupportivetherapyisneededalloverthecourse. %K 肝门胆管癌 %K 老年 %K 围手术期 %U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201008016