POSSUM及P-POSSUM评分系统对胃肠外科老年患者手术风险度的评价  

POSSUM and P-POSSUM scoring system for evaluation of the operation risk in aged patients with gastrointestinal disease

作　　者：刘战丛[1] 王丽萍[1] 李贺鹏[1] 

机构地区：[1]漯河医学高等专科学校第二附属医院普外科,河南漯河462300

出　　处：《中国实用医刊》2014年第7期13-15,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨术前使用POSSUM和P-POSSUM评分系统预测胃肠外科老年患者术后并发症和病死率的准确性。方法以POSSUM和P-POSSUM各项指标对2004年1月至2011年7月漯河医学高等专科学校第二附属医院胃肠外科收治的262例年龄〉60岁的老年手术患者进行前瞻性的评估，并与患者实际并发症、死亡情况进行比较。以卡方检验、非参数独立样本t检验、预测值和实际并发症及病死率符合度（0E比率）等统计方法评价POSSUM和P-POSSUM预测的准确性。结果POSSUM预测并发症发生数为103例（39．31％），实际发生数为69例（26．34％）；P-POSSUM预测死亡数为38例（14．89％），实际死亡12例（4．51％），差异均有统计学意义（P〈0．05）。在高危机组（R1〉50，R2〉50），POSSUM预测并发症发生数55例（73．33％），实际发生46例（61．33％）；P-POSSUM预测死亡数6例（100％），实际死亡5例（82．67％），差异无统计学意义（P〉0．05）。预测和实际并发症和病死率符合度约等于1；而低危机组（R1〈50，R2〈50）并发症和病死率被高估，预测和实际并发症率和病死率约大于1。结论POS-SUM和P-POSSUM评分系统能很好地预测胃肠外科高危组老年患者手术后并发症率和病死率。Objective To investigate the accuracy of POSSUM and P-POSSUM scoring system for prediction of complications and mortality in aged gastrointestinal surgery patients. Methods From Jan 2004 to Jul 2011, the 262 aged patients （ 〉 60 years old） were prospectively evaluated by POSSUM and P-POSSUM scoring system, and was compared with the real complications and mortality. Chi-square test, nonparametric independent samples t-test, the predicted value and the actual complications and mortality conformity （OE ra- tio） and other statistical methods were used to evaluate POSSUM and P-POSSUM predictive accuracy. Results The POSSUM predicted numbers of complications was 103 cases （39.31%）, the actual number was 69 ca- ses （26.34%） ; the P-POSSUM predicted number of deaths was 38 cases （ 14. 89% ）, the actual mortality rate was 12 cases （4.5%）, the differences were statistically significant （P 〈 0. 05） ; In＇high-risk units （ R1 〉 50, R2 〉50）, the POSSUM predicted number of complications was 55 cases （73.33%）, the actual occurrence was 46 cases （61.33%） ;the P-POSSUM predicted deaths was 6 cases （ 100% ）, the actual death was 5 cases （82.67%）, the difference was not statistically significant（P 〉0.05）. Forecast and the actual degree of com- plications and mortality was approximately equal to one accord; while in the low group （R1 〈 50, R2 〈 50）, the incidences of complications and death were overevaluated, forecasts and actual morbidity and mortality rate was greater than 1. Conclusions POSSUM and P-POSSUM scoring system can be used for prediction of com- plications and mortality in aged gastrointestinal surgery patients.

关 键 词：POSSUM P-POSSUM 胃肠外科 手术风险 手术后病发症 病死率 

分 类 号：R656[医药卫生—外科学]