E—PASS系统预测直肠癌术后近期并发症风险  

Prediction of short - term postoperative complications by E - PASS in rectal cancer patients

作　　者：唐之韵 高强[1] 方超 窦倩慧 蒲天婕 汪晓东[2] 李立[2] 

机构地区：[1]四川大学华西临床医学院／MCQ团队,四川大学华西临床医学院,成都640001 [2]四川大学华西医院胃肠中心

出　　处：《临床外科杂志》2011年第6期394-396,共3页Journal of Clinical Surgery

基　　金：基金项目：四川省卫生厅科学研究项目（080271）

摘　　要：目的采用E—PASS评分系统预测结直肠癌患者择期手术风险，探讨其对术后并发症风险预测的意义。方法回顾性分析2009年9月至2010年5月期间符合纳人标准的直肠癌患者，使用E—PASS评分系统评估其手术风险，并比较E—PASS中的PRS、SSS和CRS评分与实际手术预后的关系。并探讨E—PASS各项指标与术后风险的关系。结果纳入分析的155例患者中，32例（20．5％）患者发生术后并发症。研究发现PRS（P〈0．001）和CRS（P〈0．001）能较好地预测术后并发症，而SSS（P＝0．901）在两组的差异无统计学意义；在并发症组与无并发症组中，年龄（P〈0．001）、严重肺部疾病（P〈0．001）、体能状态指数（P〈0．001）、手术切口程度（P=0．014）、失血量／体重（P=0．046）和手术时间（P〈0．001）与并发症的发生相关，差异有统计学意义。结论E—PASS评分系统是一个相对方便有效，易操作的手术风险评估系统，能够预测直肠癌患者的术后短期并发症发生率。Objective To evaluate the value of E - PASS in predicting postoperative complications in patients who had undergone elective rectal surgery. Methods Clinical data of patients who underwent rectal cancer surgery between September 2009 to May 2010 in our hospital were analyzed retrospectively. E - PASS equations were applied to estimate the operative risk in those patients. The relationship of the preoperative risk score（ PRS）, surgical stress score（SSS） and comprehensive risk score （CRS）of the E - PASS and actual postoperative prognosis was examined. The variables of E - PASS associated with mor- bidity after colorectal cancer surgery were identified. Results Of the 155 patients,32（20.5% ） developed postoperative complications. PRS（P 〈0.001 ）and CRS（P 〈0.0001 ）but not SSS were found to be statisti- cally associated with the postoperative complications. Of all the E - PASS variables, age （ P 〈 0.001 ）, pres- ence or absence of severe pulmonary disease（ P 〈 0.001 ）, and morbidity were significantly correlated to performance status（ P 〈 0. 0001 ）, degree of surgical incision （ P = 0. 014 ）, loss of blood volume/body weight （ P = 0.046） and operation time （ P 〈 0. 001 ）. Conclusions The E - PASS scoring system is a rela- tively simple,fast and user- friendly tool that can be used to predict short -term postoperative morbidity accurately.

关 键 词：直肠癌 生理能力 手术侵袭度 术后 并发症 

分 类 号：R656.61[医药卫生—外科学]