更多内容请点击

中国全科医学 ›› 2018, Vol. 21 ›› Issue (16): 1970-1973.DOI: 10.3969/j.issn.1007-9572.2018.16.013

• 专题研究 • 上一篇    下一篇

生理能力与手术应激评分系统对食管癌术后并发症的预测价值研究

华克胜   

  1. 274030山东省菏泽市，菏泽市立医院肿瘤外科
  • 出版日期:2018-06-05 发布日期:2018-06-05

Value of Estimation of Physiologic Ability and Surgical Stress in Predicting the Postoperative Complications of Esophageal Cancer　

  1. Surgical Oncology of Heze Municipal Hospital，Heze 274030，China
  • Published:2018-06-05 Online:2018-06-05

PDF
分享到

摘要： 目的　研究生理能力与手术应激评分系统（E-PASS）预测食管癌患者术后并发症的价值。方法　选取2008年6月—2016年6月于菏泽市立医院肿瘤科治疗的740例食管癌患者为研究对象，根据术后围术期是否发生术后并发症将患者分为对照组601例和并发症组139例。收集两组患者性别、年龄、既往心脏病病史、是否患肺部疾病、是否患糖尿病、体能状态指数分级、美国麻醉医师协会（ASA）分级、失血量/体质量、手术时间、切口大小等风险指标相关资料，计算术前风险分数（PRS）、手术应激分数（SSS）及综合风险分数（CRS），比较两组上述指标的差异。采用Logistic回归分析食管癌患者术后并发症的影响因素；采用受试者工作特征（ROC）曲线评估CRS对食管癌患者术后并发症的预测价值。结果　两组性别、年龄、既往心脏病病史、是否患糖尿病、体能状态指数、ASA分级、失血量/体质量、PRS得分、SSS得分、CRS得分比较，差异有统计学意义（P<0.05）；是否患肺部疾病、手术时间、切口大小比较，差异无统计学意义（P>0.05）。Logistic回归分析结果显示，ASA分级是食管癌患者术后发生并发症的影响因素（P<0.05）。CRS对食管癌患者术后并发症预测的ROC曲线下面积为0.870〔95%CI（0.823，0.891）〕，最佳截断点为0.588，对应的灵敏度和特异度分别为91.4%和65.6%。结论　E-PASS对食管癌患者术后并发症的发生具有很好的预测价值。

关键词: 食管肿瘤, 术后并发症, 生理能力与手术应激评分系统

Abstract: Objective　To study the value of estimation of physiological ability and surgical stress（E-PASS） in predicting the postoperative complications of esophageal cancer.Methods　We enrolled 740 cases of esophageal cancer treated in Department of Oncology，Heze Municipal Hospital from June 2008 to June 2016，and 139 of whom with postoperative complications during the perioperative period and 601 without were assigned to complication group and control group，respectively.We collected and compared their data possibly related to the risk for post complications（sex，age，previous history of heart disease，whether having lung diseases，wether having diabetes，performance status classification，ASA physical status classification，intraoperative blood loss/body weight，duration of surgery and size of incision），and calculated preoperative risk score（PRS），surgical stress score（SSS） and comprehensive risk score（CRS）．Logistic regression analysis was carried out to explore the factors associated with postoperative complications.And receiver operating characteristic（ROC） curve analysis was implemented to investigate the predictive value of CRS for postoperative complications.Results　Significant differences were found between the groups in terms of the distribution of sex，age，past history of heart disease，prevalence of diabetes，distribution of performance status classification and ASA physical status classification，blood lose/bady mass，average PRS，SSS and CRS（P<0.05），but not in terms of prevalence of lung disease，average duration of surgery and average size of incision（P>0.05）．The results of Logistic regression analysis suggested that ASA physical status classification was a risk factor for postoperative complications in patients after esophageal cancer surgery.For predicting postoperative complications of esophageal cancer patients by CRS，its AUC was 0.870〔95%CI（0.823，0.891）〕，and the optimal cut off point was 0.588，corresponding sensitivity and specificity were 91.4% and 65.6%，respectively.Conclusion　E-PASS can well predict the incidence of postoperative complications in patients with esophageal cancer.

Key words: Esophageal cancer, Postoperative complications, Estimation of physiologic ability and surgical stress

冀ICP备12018774号-6　冀公网安备 13040302001295号　网站版权 © 《中国全科医学》编辑部　技术支持：北京玛格泰克科技发展有限公司