CAJ | 학술논문

目的评估大不列颠和爱尔兰结直肠协会(Association of Coloproctology of Great Britain and Ireland,ACPGBI)评分系统在国内的临床应用价值.方法回顾性分析1992-2005年904例结直肠癌患者的临床资料,其中结肠癌525例,直肠癌379例.按照手术时机、疾病种类将病例分为急诊手术组、非急诊手术组;结直肠专科医师手术组、其他外科医师手术组;结肠癌组、直肠癌组.分别计算各组预测病死率,根据ACPGBI评分计算预测结果,并与实际结果进行比较.数据采用t检验、x2检验、受试者工作特征曲线-ROC(receiver operator characteristic curve)、拟合优度(goodness-of-fit)检验、不同危险因素群的O:E比,并分组进行评判.结果术后30天内实际病死率1.0%(9/904).ACPGBI预测病死率为8.3%(75/904).对于急诊手术组、非急诊手术组、专科医生手术组、非专科医生手术组、结肠癌组和直肠癌组,预测值均偏高.病死率预测高的组,实际病死率也高.结论 ACPGBI预测病死率高于结直肠癌手术后实际病死率.ACPGBI预测结直肠癌手术后病死率的趋势,有一定临床意义.
목적 평고대불렬전화애이란결직장협회(Association of Coloproctology of Great Britain and Ireland,ACPGBI)평분계통재국내적림상응용개치.방법 회고성분석1992-2005년904례결직장암환자적림상자료,기중결장암525례,직장암379례.안조수술시궤、질병충류장병례분위급진수술조、비급진수술조;결직장전과의사수술조、기타외과의사수술조;결장암조、직장암조.분별계산각조예측병사솔,근거ACPGBI평분계산예측결과,병여실제결과진행비교.수거채용t검험、x2검험、수시자공작특정곡선-ROC(receiver operator characteristic curve)、의합우도(goodness-of-fit)검험、불동위험인소군적O:E비,병분조진행평판.결과 술후30천내실제병사솔1.0%(9/904).ACPGBI예측병사솔위8.3%(75/904).대우급진수술조、비급진수술조、전과의생수술조、비전과의생수술조、결장암조화직장암조,예측치균편고.병사솔예측고적조,실제병사솔야고.결론 ACPGBI예측병사솔고우결직장암수술후실제병사솔.ACPGBI예측결직장암수술후병사솔적추세,유일정림상의의.
Objective To evaluate a score system(Association of Coloproctology of Great Britain and Ireland ACPGBI)in prediction of postoperative mortality from colorectal cancer patients in a Chinese hospital. Methods We analyzed retrospectively 904 patients with histologically confirmed colorectal cancer who had colorectal surgery from 1992 to 2005.There were 525 colonic cancer patients and 379 rectal cancer patients.We divided patients into several groups according to operative urgency(elective or emergency);surgeons(colorectal specialists or other surgeons);cancer location(colon or rectal).According to ACPGBI score we got the prediction.This prediction was compared with the actual mortality;Chi-square test,receiver operator characteristic curve(ROC),Hosmer-Lemeshow goodness-of-fit test were used.Results Observed overall mortality within 30 days after surgery was 1.0%(9/904),and the predicted mortality was 8.3%(75/904).In all the subgroups the predicted momdity wag higher than observed mortality.We found that the actual mortality was higher in an individual subgroup in which the predicted mortality was higher. Conclusions For colorectal cancer patients undergoing a surgery the predicted mortality of ACPGBI score system was higher than the actual mortality in a Chinese hospital.