中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2011年
1期
53-56
,共4页
于健春%葛军娜%唐云%吴健雄%肖刚%于波%尉承泽%王岩%梁斌%康维明%杨华%郑朝旭%王文跃%马志强
于健春%葛軍娜%唐雲%吳健雄%肖剛%于波%尉承澤%王巖%樑斌%康維明%楊華%鄭朝旭%王文躍%馬誌彊
우건춘%갈군나%당운%오건웅%초강%우파%위승택%왕암%량빈%강유명%양화%정조욱%왕문약%마지강
胃肿瘤%结直肠肿瘤%贫血%外科手术
胃腫瘤%結直腸腫瘤%貧血%外科手術
위종류%결직장종류%빈혈%외과수술
Stomach neoplasms%Colorectal neoplasms%Anemia%Surgical procedures,operative
目的 明确胃、结直肠恶性肿瘤患者手术前后肿瘤性贫血、缺铁性贫血的发生率及其治疗现状.方法 前瞻性收集2009年8月至12月在北京市8家综合医院明确诊断为胃、结直肠恶性肿瘤的患者共262例,检测术前、术后7 d空腹静脉血血红蛋白、血清铁及铁蛋白水平,分析患者手术前后肿瘤性贫血和缺铁性贫血的发生率.结果 在131例胃癌患者中,手术前肿瘤相关性贫血发生率为36.6%,缺铁性贫血发生率为52.1%,其中贫血患者平均年龄高于无贫血患者年龄[(62±11)岁比(57±12)岁,P＜0.05];手术后缺铁性贫血发生率升至72.6%,明显高于术前(P＜0.05).131例结直肠癌患者手术前肿瘤相关性贫血发生率为37.4%,缺铁性贫血发生率为61.2%,其中45%贫血患者结肠肿瘤部位为右半结肠癌;手术后缺铁性贫血发生率明显高于术前(76.7%,P＜0.05).消化道肿瘤性贫血的术前治疗率为10.3%,术后治疗率为22.7%,半数以上的肿瘤性贫血患者接受了输血治疗.结论 胃、结直肠恶性肿瘤患者中缺铁性贫血及肿瘤相关性贫血发生率高,主要病因为缺铁性贫血.老年患者、右半结肠癌患者中贫血发生率高.贫血患者接受治疗比例较低,需要建立系统的肿瘤性贫血治疗规范.
目的 明確胃、結直腸噁性腫瘤患者手術前後腫瘤性貧血、缺鐵性貧血的髮生率及其治療現狀.方法 前瞻性收集2009年8月至12月在北京市8傢綜閤醫院明確診斷為胃、結直腸噁性腫瘤的患者共262例,檢測術前、術後7 d空腹靜脈血血紅蛋白、血清鐵及鐵蛋白水平,分析患者手術前後腫瘤性貧血和缺鐵性貧血的髮生率.結果 在131例胃癌患者中,手術前腫瘤相關性貧血髮生率為36.6%,缺鐵性貧血髮生率為52.1%,其中貧血患者平均年齡高于無貧血患者年齡[(62±11)歲比(57±12)歲,P＜0.05];手術後缺鐵性貧血髮生率升至72.6%,明顯高于術前(P＜0.05).131例結直腸癌患者手術前腫瘤相關性貧血髮生率為37.4%,缺鐵性貧血髮生率為61.2%,其中45%貧血患者結腸腫瘤部位為右半結腸癌;手術後缺鐵性貧血髮生率明顯高于術前(76.7%,P＜0.05).消化道腫瘤性貧血的術前治療率為10.3%,術後治療率為22.7%,半數以上的腫瘤性貧血患者接受瞭輸血治療.結論 胃、結直腸噁性腫瘤患者中缺鐵性貧血及腫瘤相關性貧血髮生率高,主要病因為缺鐵性貧血.老年患者、右半結腸癌患者中貧血髮生率高.貧血患者接受治療比例較低,需要建立繫統的腫瘤性貧血治療規範.
목적 명학위、결직장악성종류환자수술전후종류성빈혈、결철성빈혈적발생솔급기치료현상.방법 전첨성수집2009년8월지12월재북경시8가종합의원명학진단위위、결직장악성종류적환자공262례,검측술전、술후7 d공복정맥혈혈홍단백、혈청철급철단백수평,분석환자수술전후종류성빈혈화결철성빈혈적발생솔.결과 재131례위암환자중,수술전종류상관성빈혈발생솔위36.6%,결철성빈혈발생솔위52.1%,기중빈혈환자평균년령고우무빈혈환자년령[(62±11)세비(57±12)세,P＜0.05];수술후결철성빈혈발생솔승지72.6%,명현고우술전(P＜0.05).131례결직장암환자수술전종류상관성빈혈발생솔위37.4%,결철성빈혈발생솔위61.2%,기중45%빈혈환자결장종류부위위우반결장암;수술후결철성빈혈발생솔명현고우술전(76.7%,P＜0.05).소화도종류성빈혈적술전치료솔위10.3%,술후치료솔위22.7%,반수이상적종류성빈혈환자접수료수혈치료.결론 위、결직장악성종류환자중결철성빈혈급종류상관성빈혈발생솔고,주요병인위결철성빈혈.노년환자、우반결장암환자중빈혈발생솔고.빈혈환자접수치료비례교저,수요건립계통적종류성빈혈치료규범.
Objectives To determine the prevalence of cancer-related anemia and iron deficiency anemia( IDA ) in patients with gastric and colorectal cancer in North of China. Methods A cross-sectional study of 262 inpatients diagnosed with gastric or colorectal cancer admitted to eight general hospitals in Beijing from August 2009 to December 2009 was performed. The blood samples were took on the day after admission and the seventh day after operation for the tests of hemoglobin, serum iron and ferritin. The morbidity of cancer-related anemia and IDA before and after the surgery was also compared respectively.Results The preoperative morbidity of cancer-related anemia was 36. 6% in 131 patients with gastric cancer, and the morbidity of IDA was 52. 1%. The mean age of the anemic patients was higher than that in cases without anemia[(62 ± 11 ) yrs vs. (57 ± 12) yrs, P ＜ 0. 05]; the postoperative morbidity of IDA increased to 72. 6% ( P ＜ 0. 05 ). In the 131 cases with colorectal cancer, the preoperative incidence of cancer-related anemia and IDA was 37. 4% and 61.2%, respectively. About 45% of the cases with anemia had a tumor in the right colon. Postoperative incidence of IDA was significantly higher than that before the surgery ( 76. 7%, P ＜ 0. 05 ). Only 10. 3% of the anemic patients were treated with chalybeate therapy before surgical procedures, and the proportion was 22. 7% after the operation. More than 50% of anemic patient received blood transfusion. Conclusions Cancer-related anemia is a common clinical manifestation in patients with gastrointestinal cancer, and anemia occurs more frequently in elder and patients with right colon tumor. The treatment to cancer-related anemia is insufficient and a systematic therapy is needed to be established.
