衰弱与老年大肠癌患者术后短期预后的相关性研究  

Correlation between frailty and postoperative short-term prognosis in elderly patients with colorectal cancer

作　　者：夏宇晓 冯秀丽[1] 郭玮 张小蝶 丁榆[1] 董嫚嫚 杨学伟[1] XIA Yuxiao;FENG Xiuli;GUO Wei;ZHANG Xiaodie;DING Yu;DONG Manman;YANG Xuewei(Department of General Surgery,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510260,China)

机构地区：[1]广州医科大学附属第二医院普通外科,广州510260

出　　处：《重庆医学》2022年第24期4213-4217,4223,共6页Chongqing medicine

基　　金：广东省普通高校基础研究与应用基础研究重点项目(2018KZDXM055);广州市卫生健康科技项目(20221A011085)。

摘　　要：目的探讨衰弱评估联合美国麻醉师协会(ASA)分级对老年大肠癌患者术后短期并发症的预测价值。方法采用目的抽样,选取广州市甘三级甲等医院住院老年患者273例进行问卷调查,调查内容包括一般资料、Fried衰弱表型评估(FP)、ASA分级、住院期间发生的并发症及出院30 d内发生的并发症资料。结果衰弱评估联合ASA分级预测术后并发症的受试者工作特征(ROC)曲线下面积(AUC)为0.879[95%置信区间(95%CI)为0.810~0.936]高于单独使用ASA分级、衰弱评估预测的0.727、0.851,且衰弱评估联合ASA分级的灵敏度为0.853,特异度为0.834,准确度为0.862,差异均有统计学意义(P<0.05),提示其能有效预测术后短期并发症的发生。结论临床护士在围手术期对老年大肠癌患者进行衰弱评估,能够有效辅助外科医师做出手术选择。Objective To explore the predictive value of frailty assessment combined with American Society of Anesthesiologists(ASA)classification for postoperative short-term complications in elderly patients with colorectal cancer.Methods The purpose sampling method was used,273 elderly inpatients in the class 3A hospitals in Guangzhou were selected for conducting the questionnaire survey.The investigation contents included the general information,Fried’s frailty phenotype assessment(FP),ASA classification,complications during hospitalization and complications within 30 d after discharge.Results The area under the curve(AUC)of frailty assessment combined with ASA grading for predicting postoperative complications was 0.879[95%confidence interval(95%CI)was 0.810-0.936],which was higher than 0.727 and 0.851 predicted by ASA classification and frailty assessment alone,moreover the sensitivity of frailty assessment combined with ASA classifcation was 0.853,the specificity was 0.834,and the accuracy was 0.862,and the differences were statistically significant(P<0.05).It was suggested that it could effectively predict the occurrence of postoperative short-term complications.Conclusion Clinical nurses assess the frailty of elderly patients with colorectal cancer during the perioperative period,which can effectively assist surgeons in making surgical choices.

关 键 词：老年人 大肠癌 衰弱 美国麻醉师协会分级 并发症 

分 类 号：R473.73[医药卫生—护理学]