POSSUM对住院脊柱外科患者肺部感染的预测价值  

Predictive value of POSSUM score for pulmonary infection in hospitalized patients with spinal surgery

作　　者：冒海敏[1] 张翠红[1] 王海燕[1] 魏燕[1] 姜相君[1] 沈鑫[1] 杨盼盼[1] 张锦荣[1] 秦丽丽[1] MAO Hai-min ZHANG Cui-hong WANG Hai-yan WEI Yan JIANG Xiang-jun SHEN Xin YANG Pan-pan ZHANG jin-rong QIN Li-li(Affiliated Hospital of Nantong University Nantong , Jiangsu 226001, China)

机构地区：[1]南通大学附属医院脊柱外科,江苏南通226001

出　　处：《中华医院感染学杂志》2017年第4期857-860,共4页Chinese Journal of Nosocomiology

摘　　要：目的探究计数死亡率和发病率的生理学和手术严重性评分(POSSUM)对住院脊柱外科患者肺部感染的预测价值,以期能为后期临床治疗提供参考。方法选取2014年8月-2016年8月医院收治371例脊柱外科住院患者为研究对象,将年龄<45岁245例患者为低龄组,年龄≥45岁126例患者为高龄组,使用POSSUM评分系统对两组患者肺部感染进行预测。结果低龄组患者手术时间、术中失血量、围手术期输血量和住院天数均显著低于高龄组患者,低龄组患者手术严重性和生理学评分较高龄组患者均低,差异有统计学意义(P<0.05);低龄组患者预测肺部感染率高于高龄组患者,实际肺部感染率低于高龄组患者,且低龄组患者实际肺部感染率显著低于预测肺部感染率,差异有统计学意义(P<0.05),高龄组患者实际与预测肺部感染率差异无统计学意义;低龄组医院感染患者共分离出致病菌15株,高龄组医院感染患者共分离出致病菌9株,两组患者的常见感染病原菌均为大肠埃希菌和粪肠球菌。结论 POSSUM评分能够较好的预测住院脊柱外科患者肺部感染的发生,且对高龄组患者的预测准确度高于低龄组。OBJECTIVE To explore the predictive value of physiological and operative severity score in the enumeration of mortality and morbidity（POSSUM）for pulmonary infection in hospitalized patients with spinal surgery,so as to provide guidance for later clinical treatment.METHODS A total of 371 cases of hospitalized patients with spinal surgery were selected as the research objects from Aug.2014 to Aug.2016 in our hospital.Totally 245 patients aged less than 45 years were set as younger group,and 126 patients aged 45 or above were set as elderly group.POSSUM scoring system was used to predict pulmonary infection in the two groups of patients.RESULTS The operation time,blood loss during operation,perioperative blood transfusion and hospitalization days of younger group were significantly lower than those in elderly group,surgery in younger group and the physiological score were less severe than those in elderly group,and the differences were statistically significant（P〈0.05）.The predicted incidence of pulmonary infection in younger group was higher than that of elderly group,the true incidence of pulmonary infection in younger group was lower than that of elderly group,the true incidence of pulmonary infection in younger group was significantly lower than the predicted incidence,and the differences were statistically significant（P〈0.05）.There was no significant difference in the true incidence and predicted incidence of pulmonary infection in elderly group.Totally 15 strains of pathogenic bacteria were isolated from infected patients of younger group,and 9strains from infected patients of elderly group.The common infections of the two groups of patients were Escherichia coli and Enterococcus faecalis.CONCLUSIONThe POSSUM score can predict hospitalization incidence of pulmonary infection in patients with spinal surgery,and the prediction of the elderly group of patients is with higher accuracy than the younger group.

关 键 词：住院脊柱外科患者 肺部感染 计数死亡率和发病率的生理学和手术严重性评分 预测 

分 类 号：R563.1[医药卫生—呼吸系统]