中国实用外科杂志

中国实用外科杂志

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E-PASS评分系统预测胃肿瘤术后并发症临床价值研究

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  1. 四川大学 a.华西医院胃肠外科中心 b.华西临床医学院，四川成都610041
  • 发布日期:2012-07-30

  • Published:2012-07-30

摘要：

目的    探讨生理能力与手术应激评分系统（E-PASS）预测胃肿瘤择期手术风险和术后早期并发症的临床应用价值。方法    前瞻性收集2011年11月至2012年2月四川大学华西医院胃肠外科中心121例胃肿瘤择期手术病人的临床资料，比较有并发症组和无并发症组的临床-手术-病理相关指标有无差异，并确定综合风险分数（CRS ）预警术后并发症的切点值。 结果    121例病人中术后并发症发生率为14.9%，有并发症组和无并发症组的年龄、性别、肿瘤组织学类型、糖尿病、体能状态指数、美国麻醉医师协会（ASA）分级、切口大小、失血量-体重比、体重、失血量、手术时间、术前风险分数（PRS）和手术应激分数（SSS）的差异无统计学意义；而两组之间术前合并严重心脏疾病（P=0.000）和严重肺部疾病（P=0.000）差异有统计学意义。有并发症组CRS高于无并发症组（P=0.043），但相关分析并未得出CRS值预警术后并发症的切点值（r＜0.400，P＞0.05）。结论    E-PASS评分系统中CRS值对预测胃肿瘤择期手术风险有一定价值，但CRS预警切点值的确定须进一步研究。

关键词: 生理能力与手术应激, 评估, 胃肿瘤, 术后并发症

Abstract:

Evaluation of E-PASS system to predict postoperative complications risk in stomach tumors surgery        PENG Nan*, HOU Qing-tao, PANG Cai-shuang, et al. *Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
Corresponding author: HU Jian-kun, E-mail: hujkwch@126.com
Abstract    Objective    To evaluate the estimation of physiologic ability and surgical stress (E-PASS) for predicting postoperative complication in elective stomach neoplasms surgery. Methods    The clinical data of 121 cases of elective stomach neoplasms surgery performed between November 2011 and February 2012 in Department of Gastrointestinal Surgery, West China Hospital, Sichuan University were collected after the research question was developed. The clinical-surgical-pathological parameters were compared between complication group and non-complication group. The cutting point of CRS for predicting postoperative  complications was analyzed. Results    In 121 cases, the incidence of postoperative complications is 14.9%. The differences of age, sex, tumor histologic types, diabetes, performance status index, ASA grade, extent of skin incision, blood loss-body weight ratio, blood loss, body weight, operation time, PRS and SSS between complication group and non-complication group were not significant statistically. Severe heart disease (P=0.000) and severe pulmonary disease (P=0.000) between the two groups have significant difference statistically. The CRS of complication group was higher than that of non-complication group (P=0.043). But the cutting point of CRS for predicting postoperative complications was not elicited (r＜0.400，P＞0.05). Conclusion    CRS of the E-PASS scoring system has some value for predicting the risk of elective stomach neoplasms surgery. But the alerting cutting point of CRS still needs further investigation.

Key words: estimation of physiologic ability and surgical stress, evaluation, stomach neoplasms, postoperative complications