POSSUM评分用于指导结直肠肿瘤围手术期治疗

Value of POSSUM for the perioperative management in colorectal cancer patients undergoing resection

目的探讨POSSUM评分对指导结直肠肿瘤患者围手术期监测及治疗的价值。方法将96例结直肠肿瘤病例分为两组,A组围手术期不评分,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组在术后立即进行POSSUM评分并指导治疗。以χ2检验比较二组术后并发症和死亡率,同时比较所有病例实际并发症、死亡率与评分预测值间的差异。结果所有病例并发症率(34%∶31%,χ2=7.16,P=0.38)和死亡率(11%∶6%,χ2=3.06,P=0.31)评分预测值与实际值差异无统计学意义;而B组术后并发症率(20%)少于A组(40%),二者差异有统计学意义(χ2=4.41,P=0.036)。结论POSSUM评分能较好地预示结直肠肿瘤手术后并发症和死亡的发生,在其预警下做好围手术期治疗,有助于减少术后并发症。

Objective To evaluate the POSSUM system for the perioperative monitoring and management of colorectal tumor patients undergoing resection. Methods In this study, 96 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 ~roups. Results The difference was not statistically significant between the prospective or resultant morbidity （34% vs. 31% , χ^2 =7. 16,P〉0.05） and mortality rate （11% vs. 6% ,χ^2 =3.06,P 〉0.05） when all cases were put together. But the observed morbidity in group B （ 20% ） was less than that in group A （ 40% ） with the difference being statistically significant （χ^2 = 4.41,P = 0. 036）. Conclusions The POSSUM methodology allows satisfactory prediction of mortality and morbidity rates in patients undergoing colorectal tumor surgery.