75岁以上高龄患者的外科决策——附133例病例报告  

Surgical decision making of elderly patients aged over 75 years——133 cases report

作　　者：史继荣[1] 刘斯[1] 赵建勋[1] 

机构地区：[1]北京大学第一医院普通外科,北京100034

出　　处：《中国现代医学杂志》2007年第15期1853-1855,1858,共4页China Journal of Modern Medicine

摘　　要：目的探讨预测高龄患者术后转归的方法,提高高龄患者手术安全性。方法回顾性分析该院2004年1月～2006年12月133例年龄在75岁以上(不含75岁)的高龄普外科手术患者的临床资料。结果POSSUM评分系统预测的术后并发症和死亡分别为51例(38.3%)和9例(7.1%),P-POSSUM评分系统计算的术后死亡为3例(2.3%),实际发生并发症和死亡分别为27例(21.5%)和2例(1.2%)。手术后发生并发症的患者的POSSUM预测值、手术评分、住院时间、住院费用、手术时间、术中输血量均明显增加。手术时间越长,并发症的发生率越高。急诊手术的术后并发症较高。结论POSSUM和P-POSSUM评分系统可以预测术后并发症率和死亡率;对于高龄患者,应该尽量缩短手术时间,避免急诊手术,减少术后并发症。[Objective] To investigate methods of predicting the outcome of operations in senile patients inorder to improve the safety of operations. [Methods] Clinical data of 133 patients over 75 years from Jan 2004 to December 2006 in our hospital was analyzed retrospectively. [Results] POSSUM predicted 51（38.3%） postoperative complications and the observed morbidity was 27 （21.5%）; POSSUM predicted 9（7.1%） deaths, P-POSSUM predicted 3 （2.3%） deaths and the observed mortality was 2 （1.2%）; Comparing patients without postoperative complications, POSSUM score, the physiological and operative severity score, length of stay, cost in hospital, operative time, blood transfusions of patients having postoperative complications significantly increased; Longer was the operative time, more was the postoperative morbidity. [Conclusion] POSSUM score and P-POSSUM score can predict postoperative morbidity and mortality; In senile patients, we should decrease duration of surgery as short as possible, in order to reduce postoperative complications.

关 键 词：高龄患者 手术转归 POSSUM评分系统 

分 类 号：R592[医药卫生—老年医学]