CAJ | 학술논문

目的探讨生理能力与手术侵袭度(E-PASS)评分系统预测结肠癌患者择期手术后并发症风险的临床应用价值.方法回顾性分析2009年8月至10月四川大学华西医院收治的符合本研究纳入标准的158例结肠癌患者的临床资料.采用E-PASS评分系统评估其手术风险,并比较E-PASS评分系统中的术前风险分数(PRS)、手术侵袭度分数(SSS)和综合风险分数(CRS)评分与实际手术预后的关系.采用多元线性回归分析E-PASS评分系统各项指标与术后风险的关系.结果纳入分析的158例患者中,经过E-PASS评分系统预评估的术后近期并发症总体发生率为19.4%±2.0%,术后实际并发症发生率为17.1%(27/158).并发症的发生与Dukes分期、体能状态指数分级、严重心脏疾病、严重肺部疾病、手术时间有关(r=0.193,0.410,0.183,0.174,0.198,P＜0.05);且PRS、CRS和SSS均具有良好的预测作用(r=0.299,0.349,0.183,P＜0.05).结论 E-PASS评分系统是一个相对方便有效,易操作的手术风险评估系统,能够准确预测结肠癌患者的术后早期并发症发生风险.
목적 탐토생리능력여수술침습도(E-PASS)평분계통예측결장암환자택기수술후병발증풍험적림상응용개치.방법 회고성분석2009년8월지10월사천대학화서의원수치적부합본연구납입표준적158례결장암환자적림상자료.채용E-PASS평분계통평고기수술풍험,병비교E-PASS평분계통중적술전풍험분수(PRS)、수술침습도분수(SSS)화종합풍험분수(CRS)평분여실제수술예후적관계.채용다원선성회귀분석E-PASS평분계통각항지표여술후풍험적관계.결과 납입분석적158례환자중,경과E-PASS평분계통예평고적술후근기병발증총체발생솔위19.4%±2.0%,술후실제병발증발생솔위17.1%(27/158).병발증적발생여Dukes분기、체능상태지수분급、엄중심장질병、엄중폐부질병、수술시간유관(r=0.193,0.410,0.183,0.174,0.198,P＜0.05);차PRS、CRS화SSS균구유량호적예측작용(r=0.299,0.349,0.183,P＜0.05).결론 E-PASS평분계통시일개상대방편유효,역조작적수술풍험평고계통,능구준학예측결장암환자적술후조기병발증발생풍험.
Objective To evaluate physiologic ability and surgical stress (E-PASS) for predicting postoperative complications in patients undergoing elective colonic surgery. Methods The clinical data of 158 patients with colonic cancer who were admitted to the West China Hospital from August to October, 2009 were retrospectively analyzed. E-PASS was applied to evaluate the surgical risk. Three indexes of the E-PASS system,including preoperative risk score (PRS), surgical stress score (SSS) and comprehensive risk score (CRS) were compared with actual postoperative outcomes. Correlation between PRS, SSS, CRS and postoperative risks was analyzed using multiple linear regression analysis. Results Of the 158 patients, 27( 17.1% ) had postoperative complications, and the predictive value was 19.4% ± 2.0% according to the E-PASS. Dukes stages, physical performance indexes, severe heart disease, severe pneumonia disease, length of operation time were correlated with the incidence of complications (r = 0. 193, 0. 410, 0. 183, 0. 174, 0. 198, P ＜ 0.05). PRS, CRS and SSS had good predictive effect on postoperative risks (r = 0. 299, 0. 349, 0. 183, P ＜ 0. 05 ). Conclusions E-PASS system is a relatively simple, fast and user friendly tool for predicting the risk of short-term postoperative complications.