CAJ | 학술논문

目的探讨生理学和手术严重程度评分(POSSUM评分)用于指导老年急腹症患者围术期监测及治疗的价值.方法选取浙江中医药大学附属宁波市中医院106例老年急腹症手术患者,按就诊时期分为2组:A组57例,围术期不评分,仅依据医师经验进行监测与治疗,对病历资料进行回顾性评分；B组49例,在术后立即进行POSSUM评分并依此指导治疗.比较2组术后并发症发生情况和病死率,同时比较所有患者实际并发症发生情况、病死率与评分预测值间的差异.结果所有患者并发症发生率(x2=6.97,P=0.47)和病死率(x2=3.27,P=0.39)评分预测值(89.1％、18.7％)与实际值(78.0％、11.1％)差异无统计学意义(P＞0.05)；而B组术后并发症发生率[30.6％(15/49)]低于A组的[47.4％(27/57)],组间差异有统计学意义(x2 =4.52,P=0.043).结论 POSSUM评分能较好地预示老年急腹症患者手术后并发症和死亡的发生.在其预警下做好围术期治疗,有助于减少术后并发症.
목적 탐토생이학화수술엄중정도평분(POSSUM평분)용우지도노년급복증환자위술기감측급치료적개치.방법 선취절강중의약대학부속저파시중의원106례노년급복증수술환자,안취진시기분위2조:A조57례,위술기불평분,부의거의사경험진행감측여치료,대병력자료진행회고성평분；B조49례,재술후립즉진행POSSUM평분병의차지도치료.비교2조술후병발증발생정황화병사솔,동시비교소유환자실제병발증발생정황、병사솔여평분예측치간적차이.결과 소유환자병발증발생솔(x2=6.97,P=0.47)화병사솔(x2=3.27,P=0.39)평분예측치(89.1％、18.7％)여실제치(78.0％、11.1％)차이무통계학의의(P＞0.05)；이B조술후병발증발생솔[30.6％(15/49)]저우A조적[47.4％(27/57)],조간차이유통계학의의(x2 =4.52,P=0.043).결론 POSSUM평분능교호지예시노년급복증환자수술후병발증화사망적발생.재기예경하주호위술기치료,유조우감소술후병발증.
Objective To evaluate the physiological and operative severity score for the enumeration of mortality and morbidity system for the perioperative monitoring and management of elderly patients with acute abdomen undergoing resection.Methods In this study,106 perioperative cases were divided into two groups.Group A was not evaluated by the POSSUM system and managed empirically; group B was recorded by POSSUM immediately at the end of operation and managed accordingly.Postoperative morbidity and mortality was compared between the two groups.Results All patients complication rate (x2 =6.97,P =0.47) and mortality (x2 =3.27,P =0.39) score predictive value (89.1％,18.7％) and the actual value (78.0％,11.1％) showed no statistical significance (P ＞ 0.05) ; the incidence of postoperative complications in group B (30.6％) was lowere than that in group A (47.4％) ; there were statistically significant difference between two groups (x2 =4.52,P =0.043).Conclusion The POSSUM methodology allows satisfactory prediction of mortality and morbidity rates in elderly patients with acute abdomen undergoing resection.