POSSUM和P-POSSUM评分系统对肝部分切除手术风险度的评估  

An evaluation of POSSUM and P-POSSUM scoring systems on surgical risk scoring in hepatectomy

作　　者：张志强[1] 蔡兵[1] 吴鸣宇[1] 

机构地区：[1]江苏省无锡市人民医院肝胆外科,214023

出　　处：《中国现代医药杂志》2010年第12期45-47,共3页Modern Medicine Journal of China

摘　　要：目的探讨POSSUM和P-POSSUM评分系统对肝切除术后并发症和死亡风险的评估。方法应用POSSUM和P-POSSUM评分系统预测133例肝切除患者术后并发症和死亡,并比较实际发生与理论预测之间的差异。结果 POSSUM预测并发症58例,实际发生35例,两者存在显著性差异(P<0.05);POSSUM及P-POSSUM预测死亡分别为9例及3例,实际死亡3例,实际发生与理论预测之间均无显著性差异(P>0.05);POSSUM和P-POSSUM预测死亡率ROC曲线下面积分别为0.974及0.982。结论对于肝切除手术,POSSUM评分系统高估了术后并发症风险,POSSUM及P-POSSUM评分系统能较准确地评估术后死亡风险,P-POSSUM评分系统可能更为准确。Objective To evaluate POSSUM and P-POSSUM scoring systems in predicting the postoperative complication and the hospital mortality for hepatectomy. Methods POSSUM and P-POSSUM scoring system predicted the postoperative complication and the hospital mortality in the 133 patients undergoing hepatectomy, while comparing the difference between actual situation with the theoretical prediction. Results 58 patients with complication were predicated by the POSSUM scoring system, and there was significant difference between 58 predicated and 35 observed morbidity（P0.05）;9 patients and 3 patients with mortality were predicated by the POSSUM and P-POSSUM scoring systems respectively, and there was no significant difference between actual situation with the theoretical prediction（P0.05）. The under-ROC curve area of the mortality rate predicted by POSSUM and P-POSSUM scoring systems were 0.974 and 0.982 respectively. Conclusion POSSUM scoring system overestimates the risk of postoperative complication in hepatectomy. POSSUM and P-POSSUM scoring systems can accurately predict the risk of operative mortality in hepatectomy, and maybe P-POSSUM scoring system is more accurate.

关 键 词：POSSUM评分系统 P-POSSUM评分系统 肝切除 

分 类 号：R657.3[医药卫生—外科学]