恶性梗阻性黄疸患者围术期并发症高危因素评分系统的研发与应用  

Invention and application of a high risk factor scoring system to predict perioperative complications for malignant obstructive jaundice patients

作　　者：王若乔[1] 李丽[2] 付立[3] 姜树坤 叶志霞[3] 

机构地区：[1]第二军医大学东方肝胆外科医院研究生队,上海200438 [2]第二军医大学东方肝胆外科医院监护室,上海200438 [3]第二军医大学东方肝胆外科医院护理部,上海200438 [4]紫金桥软件技术开发有限公司

出　　处：《护理学杂志》2010年第10期1-3,共3页

基　　金：上海市重点学科建设基金项目(B903)

摘　　要：目的客观、准确、快速地筛选出恶性梗阻性黄疸患者围术期并发症发生的高危人群,以采取针对性措施预防和控制并发症。方法收集整理841例恶性梗阻性黄疸行手术治疗患者的临床资料,在医学统计学教研室的帮助下完成出血、胰漏、肾功能不全的高危因素及Fisher′s判别方程的计算,与软件公司合作,将出血、胰瘘、肾功能不全高危因素分类排版,Fisher′s判别方程编入程序,形成恶性梗阻性黄疸患者围手术期并发症高危因素评分系统软件。将该软件应用于62例恶性梗阻性黄疸患者,将患者相关资料输入软件后系统筛选并发症发生的高危人群。结果评分系统软件对出血、胰瘘、肾功能不全检出的灵敏度分别为85.7%、88.9%、100%;特异度分别为94.5%、96.2%、96.5%;预测符合率分别为93.6%、95.2%、96.8%,平均每例患者的计算时间缩短426.92s。结论恶性梗阻性黄疸患者围术期并发症高危因素评分系统能快速、准确筛选出围术期并发症发生的高危人群,为预测患者围手术期情况提供参考。Objective To objectively,accurately and swiftly screen malignant obstructive jaundice patients with high risk of perioperative complication,and to provide information for prevention and control of complications. Methods The surgical data of 841 malignant obstructive jaundice patients were collected. With the help of medical statistics teachers,such high risk factors as hemorrhage,pancreatic fistula and renal insufficiency were identified and Fisher＇s Discriminant Function was calculated. The identified perioperative complications were grouped and typeset with the help of software company,which also edited Fisher＇s Discriminant Function into a program. The program was then developed into a high risk factor scoring system for malignant obstructive jaundice patients. The data of 62 patients were input into the system and those with high risk of perioperative complications were screened out. Results The software＇s sensitivity of hemorrhage,pancreatic fistula and renal insufficiency were 85.7%,88.9% and 100% respectively,with the specificity being 94.5%,96.2%,and 96.5% respectively. The coincidence rates of prediction of the above 3 complications were 93.6%,95.2% and 96.8% respectively,and the calculation time for each patient was 426.92 s shorter. Conclusion The high risk factor scoring system for malignant obstructive jaundice patients can be used to swiftly and conveniently screen patients with high risk of perioperative complication. It can provide information for predicting patients＇ perioperative conditions.

关 键 词：恶性梗阻性黄疸 围术期 高危因素 评分系统 并发症 出血 胰漏 肾功能不全 

分 类 号：R473.6[医药卫生—护理学] C931.6[医药卫生—临床医学]