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高龄患者胃肠肿瘤术后并发症的危险因素

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目的 探讨高龄患者胃肠肿瘤术后并发症的危险因素.方法 选择2016年1月-2017年1月行胃肠道肿瘤手术的高龄患者242例进行回顾性分析,收集术前一般资料、术前合并症、术前实验室检查及其他检查指标、手术及麻醉相关因素.采用单因素和多因素logistic回归模型对术后并发症的影响因素进行统计分析.结果 共71例(29.34%)患者在住院期间发生术后并发症.单因素分析结果显示:并发症患者与无并发症患者在美国麻醉医师协会分级、美国纽约心脏病学会心功能分级、Barthel指数、是否行微创手术、术前慢性肾功能不全、术前肺影像异常、术前血尿素氮水平、术前活化部分凝血活酶时间和手术时长比较,差异均有统计学意义(P<0.05).多因素logistic回归分析显示:Barthel指数≤60、手术时长和术前肺影像异常是高龄患者胃肠肿瘤术后并发症发生的独立危险因素(P<0.05),微创手术方式是其保护因素(P<0.05).结论 Barthel指数≤60、手术时长和术前肺影像异常的胃肠肿瘤高龄患者术后具有较高的并发症发生风险,应加以关注.
Risk factors of postoperative complications of gastrointestinal tumor in elderly patients
Objective To investigate the risk factors of postoperative complications of gastrointestinal tumors in elderly pa-tients.Methods A total of 242 elderly patients undergoing elective gastrointestinal tumor surgery from January 2016 to January 2017 were selected for retrospective analysis,and preoperative general conditions,preoperative complications,preoperative laboratory tests and other examination indicators,surgical and anesthesia-related factors were collected.Univariate and multivariate logistic regression analysis were used to statistically analyze the influencing factors of postoperative complications.Results A total of 71(29.34%)pa-tients developed postoperative complications during hospitalization.Univariate analysis showed that there were significant differences in American Society of Anesthesiologists classification,New York Heart Association classification,Barthel index,minimally invasive sur-gery,preoperative chronic renal insufficiency,preoperative abnormal lung imaging,preoperative urea nitrogen level,preoperative acti-vated partial thromboplastin time and operation time between patients with complications and those without complications(P<0.05).Multivariate logistic regression analysis showed that Barthel index ≤60,operation time and abnormal preoperative lung imaging were independent risk factors for postoperative complications of gastrointestinal tumors in elderly patients(P<0.05),and minimally invasive surgery was a protective factor(P<0.05).Conclusion Elderly patients with gastrointestinal tumors with Barthel index ≤60,length of operation,and abnormal preoperative lung images have a higher risk of postoperative complications and should be concerned.

Elderly patientsGastrointestinal tumorPostoperative complicationsRisk factors

梁会秋、罗艳

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上海交通大学医学院附属第九人民医院麻醉科,上海 200011

上海交通大学医学院附属瑞金医院麻醉科,上海 200025

高龄患者 胃肠肿瘤 术后并发症 危险因素

2025

国际老年医学杂志
吉林大学

国际老年医学杂志

影响因子:0.435
ISSN:1674-7593
年,卷(期):2025.46(1)