CAJ | 학술논문

目的：探讨老年肝脏手术的围手术期处理经验。方法对2005年1月至2015年1月189例60岁以上的老年肝脏手术的围手术期病人与同期胃肠外科60岁左右胃癌根治术161例病人进行对比做回顾性分析。结果老年肝脏手术病人术后出血、肝功能障碍、黄疸、肺部感染、切口感染、肝脓肿的并发症要高于老年胃癌根治病人。结论老年人肝脏手术围手术期术后渗血明显增多，凝血机制障碍更明显，术后应输血浆和白蛋白，密切观察凝血功能变化，以及少尿，肾功能不全的发生，纠正电解质紊乱，维持酸碱平衡，合理使用抗生素，选择合理的营养支持是手术成功的关键。
목적：탐토노년간장수술적위수술기처리경험。방법대2005년1월지2015년1월189례60세이상적노년간장수술적위수술기병인여동기위장외과60세좌우위암근치술161례병인진행대비주회고성분석。결과노년간장수술병인술후출혈、간공능장애、황달、폐부감염、절구감염、간농종적병발증요고우노년위암근치병인。결론노년인간장수술위수술기술후삼혈명현증다，응혈궤제장애경명현，술후응수혈장화백단백，밀절관찰응혈공능변화，이급소뇨，신공능불전적발생，규정전해질문란，유지산감평형，합리사용항생소，선택합리적영양지지시수술성공적관건。
Objective To explore the perioperative management measures of hepatic surgery in elders.Methods A total of 1 89 hepatic surgical patients aged over 60 years from January 2005 to Jan-uary 201 5 and 161 gastric cancer surgical patients aged around 60 years from January 2005 to January 201 5 were compared and retrospectively analyzed.Results There were postoperative hemorrhage (n=43),hepatic dysfunction with elevated levels of alanine aminotransferase (ALT)& aspartate amin-otransferase (AST)(n=101),jaundice (n=30),pulmonary infection (n=19),wound infection (n=10)and liver abscess (n =5 ).Conclusions During hepatic surgery,perioperative and postoperative hemorrhage and coagulation disorders are evident.Transfusion of plasma and albumin and close moni-toring of blood coagulation are necessary.For oliguria and renal dysfunction,electrolyte disturbance should be corrected and acid-base balance maintained.Rational use of antibiotics and proper nutritional supports are vital for successful surgery.