APACHEⅡ及MODS评分与肿瘤术后患者预后的相关性研究  

Correlation between APACHE Ⅱ and MODS Score and Prognosis of Patients after Tumor Resection

作　　者：王成连 蓝小林 叶永强 罗忠兵 曾国兴 WANG Chenglian;LAN Xiaolin;Ye Yongqiang(Ganzhou Tumor Hospital,Ganzhou 341000,China)

机构地区：[1]江西省赣州市肿瘤医院,江西赣州341000

出　　处：《中国医学创新》2017年第32期57-60,共4页Medical Innovation of China

基　　金：江西省卫生计生委科技计划项目(20142266)

摘　　要：目的:探究APACHEⅡ评分结合多器官功能不全(MODS)评分系统对食管癌术后患者死亡预后的预测价值。方法:收集预试验期和2014年7月-2015年12月于本院进行食管癌开胸切除手术的80例患者的临床资料,按术后住院期间是否死亡分为死亡组和存活组;两组患者均于食管癌开胸手术术后入住ICU,进行MODS评分,且于入住后第1、3、5天分别进行APACHEⅡ评分;运用多变量COX比例风险模型分析MODS评分分值对死亡预后的预测价值,并且分析肿瘤术后MODS的发生与APACHEⅡ评分及MODS评分的相关性。结果:食管癌术后患者APACHEⅡ评分高低与患者预后存在相关性,APACHEⅡ评分分值越高,肿瘤术后患者的病情越重;并且,随着MODS评分增加,患者病死率增加;但是,APACHEⅡ评分预测病死率的准确性受MODS的影响较大,使得低分区预测值显著高于实际值,高峰期预测值显著低于实际值;多因素COX比例风险模型分析提示食管癌术后患者的预后指数为:PI=1.679×并发MODS+0.854×APACHEⅡ评分+1.079×MODS评分。结论:应用APACHEⅡ及MODS评分综合评估系统对肿瘤手术后患者的预后评估,可以使肿瘤手术后患者的预后评估更加具有可靠性和准确性。Objective:To explore the prognostic value of APACHEⅡscoring system combined with MODS scoring system in the prognosis of esophageal cancer patients after operation.Method:Clinical data of 80 patients who underwent preoperative trial from July 2014 to December 2015 for esophagectomy of thoracotomy in our hospital,according to postoperative death during hospitalization they were divided into death group and survival group.Patients of two groups were in thoracic esophageal cancer after surgery in ICU,MODS score on the first,third,fifth day APACHE score were given.Using multivariate COX proportional hazard model analyzed the value of MODS score in predicting the prognosis of death,the correlation of MODS and APACHE score and MODS score after tumor resection were analyzed.Result:The postoperative esophageal cancer patients APACHEⅡscore correlated with prognosis,APACHEⅡscore was higher,postoperative tumor patients with more serious illness.With the increase of MODS score,mortality increased.However,the accuracy of APACHEⅡscore in predicting mortality was seriously affected by MODS,the low partition prediction value was significantly higher than the actual value and predictive value of the peak was significantly lower than the actual value.COX multivariate analysis suggested that postoperative esophageal cancer prognosis index was PI=1.679×MODS+0.854×APACHEⅡscore+1.079×MODS score.Conclusion:The application of APACHEⅡand MODS scoring system to evaluate the prognosis of patients after tumor operation can make the prognosis evaluation more reliable and accurate.

关 键 词：APACHEⅡ评分 MODS评分 食管癌术后 病死率 多因素COX回归 

分 类 号：R735.1[医药卫生—肿瘤]