中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
7期
13-15
,共3页
POSSUM%P-POSSUM%胃肠外科%手术风险%手术后病发症%病死率
POSSUM%P-POSSUM%胃腸外科%手術風險%手術後病髮癥%病死率
POSSUM%P-POSSUM%위장외과%수술풍험%수술후병발증%병사솔
POSSUM%P-POSSUM%Gastrointestinal surgery%Surgical risk%Postoperative complications%Mortality rate
目的 探讨术前使用POSSUM和P-POSSUM评分系统预测胃肠外科老年患者术后并发症和病死率的准确性.方法 以POSSUM和P-POSSUM各项指标对2004年1月至2011年7月漯河医学高等专科学校第二附属医院胃肠外科收治的262例年龄＞60岁的老年手术患者进行前瞻性的评估,并与患者实际并发症、死亡情况进行比较.以卡方检验、非参数独立样本t检验、预测值和实际并发症及病死率符合度(OE比率)等统计方法评价POSSUM和P-POSSUM预测的准确性.结果 POSSUM预测并发症发生数为103例(39.31％),实际发生数为69例(26.34％);P-POSSUM预测死亡数为38例(14.89％),实际死亡12例(4.51％),差异均有统计学意义(P＜0.05).在高危机组(R1 ＞50,R2 ＞50),POSSUM预测并发症发生数55例(73.33％),实际发生46例(61.33％);P-POSSUM预测死亡数6例(100％),实际死亡5例(82.67％),差异无统计学意义(P＞0.05).预测和实际并发症和病死率符合度约等于1;而低危机组(R1 ＜50,R2 ＜50)并发症和病死率被高估,预测和实际并发症率和病死率约大于1.结论 POSSUM和P-POSSUM评分系统能很好地预测胃肠外科高危组老年患者手术后并发症率和病死率.
目的 探討術前使用POSSUM和P-POSSUM評分繫統預測胃腸外科老年患者術後併髮癥和病死率的準確性.方法 以POSSUM和P-POSSUM各項指標對2004年1月至2011年7月漯河醫學高等專科學校第二附屬醫院胃腸外科收治的262例年齡＞60歲的老年手術患者進行前瞻性的評估,併與患者實際併髮癥、死亡情況進行比較.以卡方檢驗、非參數獨立樣本t檢驗、預測值和實際併髮癥及病死率符閤度(OE比率)等統計方法評價POSSUM和P-POSSUM預測的準確性.結果 POSSUM預測併髮癥髮生數為103例(39.31％),實際髮生數為69例(26.34％);P-POSSUM預測死亡數為38例(14.89％),實際死亡12例(4.51％),差異均有統計學意義(P＜0.05).在高危機組(R1 ＞50,R2 ＞50),POSSUM預測併髮癥髮生數55例(73.33％),實際髮生46例(61.33％);P-POSSUM預測死亡數6例(100％),實際死亡5例(82.67％),差異無統計學意義(P＞0.05).預測和實際併髮癥和病死率符閤度約等于1;而低危機組(R1 ＜50,R2 ＜50)併髮癥和病死率被高估,預測和實際併髮癥率和病死率約大于1.結論 POSSUM和P-POSSUM評分繫統能很好地預測胃腸外科高危組老年患者手術後併髮癥率和病死率.
목적 탐토술전사용POSSUM화P-POSSUM평분계통예측위장외과노년환자술후병발증화병사솔적준학성.방법 이POSSUM화P-POSSUM각항지표대2004년1월지2011년7월탑하의학고등전과학교제이부속의원위장외과수치적262례년령＞60세적노년수술환자진행전첨성적평고,병여환자실제병발증、사망정황진행비교.이잡방검험、비삼수독립양본t검험、예측치화실제병발증급병사솔부합도(OE비솔)등통계방법평개POSSUM화P-POSSUM예측적준학성.결과 POSSUM예측병발증발생수위103례(39.31％),실제발생수위69례(26.34％);P-POSSUM예측사망수위38례(14.89％),실제사망12례(4.51％),차이균유통계학의의(P＜0.05).재고위궤조(R1 ＞50,R2 ＞50),POSSUM예측병발증발생수55례(73.33％),실제발생46례(61.33％);P-POSSUM예측사망수6례(100％),실제사망5례(82.67％),차이무통계학의의(P＞0.05).예측화실제병발증화병사솔부합도약등우1;이저위궤조(R1 ＜50,R2 ＜50)병발증화병사솔피고고,예측화실제병발증솔화병사솔약대우1.결론 POSSUM화P-POSSUM평분계통능흔호지예측위장외과고위조노년환자수술후병발증솔화병사솔.
Objective To investigate the accuracy of POSSUM and P-POSSUM scoring system for prediction of complications and mortality in aged gastrointestinal surgery patients.Methods From Jan 2004 to Jul 2011,the 262 aged patients (＞ 60 years old) were prospectively evaluated by POSSUM and P-POSSUM scoring system,and was compared with the real complications and mortality.Chi-square test,nonparametric independent samples t-test,the predicted value and the actual complications and mortality conformity (OE ratio) and other statistical methods were used to evaluate POSSUM and P-POSSUM predictive accuracy.Results The POSSUM predicted numbers of complications was 103 cases (39.31％),the actual number was 69 cases (26.34％) ; the P-POSSUM predicted number of deaths was 38 cases (14.89％),the actual mortality rate was 12 cases (4.5％),the differences were statistically significant (P ＜0.05); In high-risk units (R1 ＞ 50,R2 ＞50),the POSSUM predicted number of complications was 55 cases (73.33％),the actual occurrence was 46 cases (61.33％) ;the P-POSSUM predicted deaths was 6 cases (100％),the actual death was 5 cases (82.67％),the difference was not statistically significant(P ＞0.05).Forecast and the actual degree of complications and mortality was approximately equal to one accord; while in the low group (R1 ＜ 50,R2 ＜ 50),the incidences of complications and death were overevaluated,forecasts and actual morbidity and mortality rate was greater than 1.Conclusions POSSUM and P-POSSUM scoring system can be used for prediction of complications and mortality in aged gastrointestinal surgery patients.
