生理能力与手术侵袭度评分系统评估髋部骨折患者手术风险的价值  

Value of estimation of physiologic ability and surgical stress in prediction of operative risk of hip fracture

作　　者：庞显伦[1] 杨建[2] 梁熙[3] 兰秀夫[4] 黄伟[3] 童松林[5] 

机构地区：[1]泸州医学院卫生所,646000 [2]重庆医科大学附属永川医院骨科 [3]重庆医科大学附属第一医院骨科 [4]重庆市江北区中医院骨科 [5]慈溪市人民医院骨科

出　　处：《中华创伤杂志》2014年第2期153-155,共3页Chinese Journal of Trauma

摘　　要：目的 采用生理能力与手术侵袭度（estimation of physiologic ability and surgical stress,E-PASS）评分系统评估髋部骨折患者的手术风险及其应用价值. 方法 回顾性分析2010年1月-2012年1月收治的64例髋部骨折患者,其中男38例,女26例；年龄19 ～ 84岁,平均54.3岁.术前应用E-PASS评分对患者手术风险进行评估,比较并发症出现率及病死率. 结果 16例出现并发症（25％）,出现并发症的患者平均E-PASS评分明显高于未出现并发症的患者[（0.64±0.31）分：（0.22±0.31）分,P＜0.05].在E-PASS评分＜0.6的患者中并发症出现率明显低于E-PASS评分＞0.6的患者（19％：50％,P＜0.01）.16例E-PASS评分＞0.6的患者中2例死亡,余48例E-PASS评分＜0.6的患者术后均恢复良好. 结论 E-PASS评分能够有效评估术前髋部骨折患者的手术风险,对患者的治疗方式选择有一定的指导意义.Objective To use estimation of physiologic ability and surgical stress （E-PASS） to assay operative risks in patients with hip fracture and to discuss its application value. Methods Sixty- four patients with hip fractures were subjected to the retrospective review. There were 38 males and 26 fe- males, at mean age of 54.3 years （range, 19-84 years）. The operative risk was assayed by E-PASS and postoperative complications as well as case fatality were detected and compared. Results Postoperative complications developed in 16 patients （25%）. E-PASS score was significantly higher for the patients with postoperative complications than in those without [ （0.64 ＋ 0.31 ） points vs （0.22 ＋ 0.31 ） points, P 〈 0.05 ]. Incidence of complications was significantly lower for patients with a E-PASS score 〈 0.6 than for those with a E-PASS score 〉0.6 （ 19% vs 50% , P 〈0.01 ）. There were 2 deaths among 16 patients with a E-PASS score 〉 0.6. The remaining 48 patients with a E-PASS score 〈 0.6 obtained satisfactory recovery. Conclusion E-PASS is effective for predicting operative risk and is instructive for surgery decision in treatment of hip fractures.

关 键 词：髋骨折 外科手术 生理能力与手术侵袭度 

分 类 号：R687.3[医药卫生—骨科学]