中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
26期
29-31
,共3页
肝硬化%终末期肝病模型%Child-Turcotte-Pugh评分
肝硬化%終末期肝病模型%Child-Turcotte-Pugh評分
간경화%종말기간병모형%Child-Turcotte-Pugh평분
Liver cirrhosis%Model for end-stage liver disease%Child-Turcotte-Pugh score
目的 研究终末期肝病模型(MELD)评分及Child-Turcotte-Pugh( CTP)评分对肝硬化患者手术预后的评估.方法 入选70例行脾切除+门奇断流术的肝硬化患者,计算术前MELD评分和CTP评分,分析两者相关性及不同分组下并发症的发生情况.以受试者工作特征(ROC)曲线下面积衡量各评分的预测能力.结果 共23例(32.9％,23/70)发生术后并发症.并发症组(23例)MELD评分和CTP评分分别为(19.58 ±5.90)分和(8.84±1.87)分,无并发症组(47例)分别为(12.27±2.94)分和(6.10±1.12)分,两组比较差异有统计学意义(P＜0.01).将患者按MELD评分进行分组:＜ 14分组(30例)、14～ 23分组(28例)、＞23分组(12例),三组并发症发生率分别为10.0％(3/30)、35.7％(10/28)和83.3％(10/12),三组并发症发生率两两比较差异均有统计学意义(P＜0.05).将患者按CTP评分进行分级:A级(29例)、B级(25例)和C级(16例),三级并发症发生率分别为10.3％(3/29)、36.0％(9/25)和68.8％(11/16),三级并发症发生率两两比较差异均有统计学意义(P＜0.05).Pearson相关性分析显示,MELD评分与CTP评分有显著相关性(r=0.874,P＜ 0.01).MELD评分和CTP评分判断患者围手术期并发症的ROC曲线下面积分别为0.877 (95％ CI:0.84～0.95)和0.852(95％ CI:0.83 ～ 0.94),两者比较差异无统计学意义(U=0.157,P＞0.05).结论 MELD评分和CTP评分均能准确预测肝硬化患者围手术期并发症,临床应用宜相互结合,以进一步提高预测准确度.
目的 研究終末期肝病模型(MELD)評分及Child-Turcotte-Pugh( CTP)評分對肝硬化患者手術預後的評估.方法 入選70例行脾切除+門奇斷流術的肝硬化患者,計算術前MELD評分和CTP評分,分析兩者相關性及不同分組下併髮癥的髮生情況.以受試者工作特徵(ROC)麯線下麵積衡量各評分的預測能力.結果 共23例(32.9％,23/70)髮生術後併髮癥.併髮癥組(23例)MELD評分和CTP評分分彆為(19.58 ±5.90)分和(8.84±1.87)分,無併髮癥組(47例)分彆為(12.27±2.94)分和(6.10±1.12)分,兩組比較差異有統計學意義(P＜0.01).將患者按MELD評分進行分組:＜ 14分組(30例)、14～ 23分組(28例)、＞23分組(12例),三組併髮癥髮生率分彆為10.0％(3/30)、35.7％(10/28)和83.3％(10/12),三組併髮癥髮生率兩兩比較差異均有統計學意義(P＜0.05).將患者按CTP評分進行分級:A級(29例)、B級(25例)和C級(16例),三級併髮癥髮生率分彆為10.3％(3/29)、36.0％(9/25)和68.8％(11/16),三級併髮癥髮生率兩兩比較差異均有統計學意義(P＜0.05).Pearson相關性分析顯示,MELD評分與CTP評分有顯著相關性(r=0.874,P＜ 0.01).MELD評分和CTP評分判斷患者圍手術期併髮癥的ROC麯線下麵積分彆為0.877 (95％ CI:0.84～0.95)和0.852(95％ CI:0.83 ～ 0.94),兩者比較差異無統計學意義(U=0.157,P＞0.05).結論 MELD評分和CTP評分均能準確預測肝硬化患者圍手術期併髮癥,臨床應用宜相互結閤,以進一步提高預測準確度.
목적 연구종말기간병모형(MELD)평분급Child-Turcotte-Pugh( CTP)평분대간경화환자수술예후적평고.방법 입선70례행비절제+문기단류술적간경화환자,계산술전MELD평분화CTP평분,분석량자상관성급불동분조하병발증적발생정황.이수시자공작특정(ROC)곡선하면적형량각평분적예측능력.결과 공23례(32.9％,23/70)발생술후병발증.병발증조(23례)MELD평분화CTP평분분별위(19.58 ±5.90)분화(8.84±1.87)분,무병발증조(47례)분별위(12.27±2.94)분화(6.10±1.12)분,량조비교차이유통계학의의(P＜0.01).장환자안MELD평분진행분조:＜ 14분조(30례)、14～ 23분조(28례)、＞23분조(12례),삼조병발증발생솔분별위10.0％(3/30)、35.7％(10/28)화83.3％(10/12),삼조병발증발생솔량량비교차이균유통계학의의(P＜0.05).장환자안CTP평분진행분급:A급(29례)、B급(25례)화C급(16례),삼급병발증발생솔분별위10.3％(3/29)、36.0％(9/25)화68.8％(11/16),삼급병발증발생솔량량비교차이균유통계학의의(P＜0.05).Pearson상관성분석현시,MELD평분여CTP평분유현저상관성(r=0.874,P＜ 0.01).MELD평분화CTP평분판단환자위수술기병발증적ROC곡선하면적분별위0.877 (95％ CI:0.84～0.95)화0.852(95％ CI:0.83 ～ 0.94),량자비교차이무통계학의의(U=0.157,P＞0.05).결론 MELD평분화CTP평분균능준학예측간경화환자위수술기병발증,림상응용의상호결합,이진일보제고예측준학도.
Objective To investigate the value of the model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) score in predicting the prognosis of patients with liver cirrhosis.Methods Seventy patients with liver cirrhosis were selected.The MELD and CTP score before surgery was calculated and was analyzed the correlation between the two models was analyzed.The prognosis ability by the area under the receiver operating characteristic (ROC) curve was evaluated.Results Twenty three cases (32.9％,23/70) appeared post operative serious complication.The scores of MELD and CTP in complication group (23 cases) was (19.58 ±5.90),(8.84 ± 1.87) scores,the scores of MELD and CTP in without complication group (47 cases) was ( 12.27 ± 2.94),(6.10 ± 1.12) scores,there were significant differences between two groups (P ＜ 0.01 ).According to the MELD score,70 patients was divided into ＜ 14 scores group(30 cases),14 - 23 scores group(28 cases),＞ 23 scores group( 12 cases),the rate of complication was 10.0％(3/30),35.7％( 10/28 ) and 83.3％(10/12),there were significant differences among three groups(P＜ 0.05).According to the CTP score,70 patients were divided into A grade(29 cases),B grade (25 cases) and C grade( 16 cases),the rate of complication was 10.3％ ( 3/29 ),36.0％ (9/25) and 68.8％ ( 11/16 ),there were significant differences among three groups (P ＜ 0.05 ).The results of Pearson correlation analysis showed that the MELD score and CTP score had significant correlation (r =0.874,P ＜ 0.01 ).The area under the ROC curve of the MELD score and CTP score in prognosis the perioperative complication was 0.877 (95％ CI:0.84 - 0.95 ) and 0.852 (95％ CI:0.83 - 0.94),there was no significant difference ( U =0.157,P ＞ 0.05 ).Conclusion Both MELD and CTP score can accurately predict the short term prognosis of patients with liver cirrhosis.
