结直肠漏评分系统预测左侧结直肠切除术后吻合口漏的分析  

Colon Leakage Score predicts the risk of anastomotic leakage after left-sided colorectomy

作　　者：喻学桥[1] 周卫平[1] 蔡国豪[1] 方壮伟[1] 王清华[1] 黄有群[1] 彭永红[1] 袁波[1] 叶木林[1] 

机构地区：[1]海南省人民医院胃肠外二科,海口570311

出　　处：《中华普通外科杂志》2015年第6期447-450,共4页Chinese Journal of General Surgery

摘　　要：目的 评价结直肠漏评分（Colon Leakage Score,CLS）系统对左侧结直肠切除术后吻合口漏的预测价值.方法 以海南省人民医院胃肠外二科接受左侧结直肠切除术的304例结直肠癌患者为研究对象,根据术后是否发生吻合口漏将患者分为有吻合口漏和无吻合口漏两组,应用ROC曲线及Logistic回归评价CLS评分系统对吻合口漏发生的预测价值并确定预测临界值.结果 有吻合口漏组与无吻合口漏组的CLS评分差异有统计学意义（F =68.23,P＜0.001）,ROC曲线下面积为0.965（CI：0.913～1.00）,OR值为2.9（CI：1.59 ～4.83,P＜0.001）,最佳临界值为“11”,预测敏感度和特异度分别为86.4％和87.2％.结论 CLS评分系统对左侧结直肠切除术后吻合口漏的发生具有良好的预测价值,CLS分值“11”可作为划分高低风险的最佳预测临界值.Objective To evaluate the Colon Leakage Score （CLS） in predicting the risk of anastomotic leakage in left-sided colorectal surgery.Methods 304 patients undergoing left-sided colorectal surgery were included in this retrospective study.The patients were divided into anastomotic leakage group and the group without anastomotic leakage.The predictive value of the CLS and the cut off value was assessed by performing operating characteristics and Logistic regression analysis.Results There are significant differences in the mean CLS sore between the leakage group and the group without leakage （P ＜ 0.001）.The area under the curve （0.965,CI：0.913-1.00） and the odds ratio （2.9,CI：1.59-4.83,P ＜0.001） showed that the CLS was a good predictor of anastomotic leakage.We select CLS of 11 as the best cut off value.The sensitivity and specificity were 86.4％ and 87.2％ respectively.Conclusions The CLS can predict the risk of anastomotic leakage following left-sided colorectal surgery.CLS of 11 is the cut off value for distinguishing ＂high＂ from ＂low＂ risk.

关 键 词：结直肠肿瘤 手术后并发症 预测 结直肠漏评分 

分 类 号：R735.2[医药卫生—肿瘤]