POSSUM评分系统预测大肠癌病人手术风险的临床意义  

Clinical significance of POSSUM scoring system in predicting the surgical risk of the colonrectal cancer

作　　者：祝利[1] 龚旭晨[1] 高维鸽[1] 艾克拜尔.苏里坦[1] 阿力马斯.阿斯哈尔 

机构地区：[1]新疆维吾尔自治区人民医院肛肠外科,乌鲁木齐830000

出　　处：《新疆医科大学学报》2011年第11期1278-1281,1285,共5页Journal of Xinjiang Medical University

摘　　要：目的应用POSSUM评分系统对大肠癌(colonrectal cancer,CRC)病人手术风险进行评估,以评价该评分的临床有效性,同时对多个手术风险的单因素进行分析,为临床治疗决策提供参考。方法对101例手术的CRC病人进行POSSUM评分,同时统计术后实际并发症发生率和病死率,并与评分预测值进行比较,就有可能产生并发症的多个因素进行比较分析。结果 POSSUM评分预测并发症发生率(58.03%)与实际并发症发生率(40.59%)较为接近,而预测病死率(11.15%)则较实际病死率(2.97%)略高;年龄、手术次数、血浆白蛋白含量、糖尿病与术后并发症的发生有关联。结论 POSSUM评分系统可以较好地预测CRC病人术后并发症发生率,但对病死率预测高于实际发生率,需结合其他评分系统协同作用,与并发症有关的4个手术风险因素应引起临床医师的高度重视。Objective To estimate the surgical risk of the colonrectal cancer patients by using physiological and operative score for the enumeration of mortality and morbidity（POSSUM） scoring system,and then to prove the reliability of the scoring system,and to analyze the multiple single factors of the surgical risk in order to acquire therapy reference.Methods The POSSUM scoring system was performed on 101 colonrectal cancer patients,and the actual complications and mortality were analyzed and compared with the predicting rate.The multiple single factors that were possibly linked with the complications were analyzed.Results The predicting complication rate and mortality were 58.03% and 11.15%,respectively,which was close to the actual results（40.59%） in 101 patients in complication rate,but the predicting mortality rate was higher than actual results（2.97%）.Single factor analysis revealed that 4 single factors had the relationship to the complications.Conclusion POSSUM scoring system can predict the postoperative complications of the colonrectal cancer patients.but the postoperative mortality rate should combined other risk-scoring system to predict.Clinical physicians should pay an attention to these 4 single factors of surgical risk.

关 键 词：大肠癌 POSSUM评分系统 手术风险 

分 类 号：R735.34[医药卫生—肿瘤]