应用APACHEⅡ和POSSUM评分指导胰腺癌患者外科治疗的临床分析

POSSUM and APACHE II for surgery in patients with pancreatic cancer

目的 探讨POSSUM和APACHEⅡ评分系统对胰腺癌患者外科治疗影响的临床价值。方法 应用POSSUM和APACHEⅡ评分系统对 84例胰腺癌患者围手术期进行回顾分析。 结果 本组患者中 ,青年组 (n =36 )的病死率和并发症分别为 5 5 %和 19 4% ,老年组 (n =48)病死率和并发症分别为 6 2 %和 2 0 8% ,略低于APACHEⅡ和POSSUM评分预测的老年组病死率 (12 5 % )和并发症(2 5 5 % ) ,中青年组病死率 (11 1% )和并发症 (2 5 % )。 结论 POSSUM和APACHEⅡ能反映胰腺癌患者的病情 ,并且可影响选择最适宜的手术方式。

ObjectiveTo evaluate the physiological and operative severity score for enumeration of mortality and morbidity (POSSUM) with Acute physiology and chronic health evaluation II (APACHE II) scoring system for surgery in patients with pancreatic cancer. [WT5”HZ]Methods[WT5”BZ] The POSSUM with APACHE II scoring system during perioperative period in 84 patients with pancreatic cancer who had accepted the surgery were analysed retrospectively. Results Consecutive series of patients who underwent surgery in Group 1 (>60 years, n =48) or Group 2 (<60 years, n =36) were analysed. Postoperative complications and 30-day mortality were recorded. In the Group 1, 48 patients underwent surgery with a mortality rate of 6 2% and a morbidity rate of 20 8%. In the Group 2, the mortality and morbidity were 5 5% and 19 4% respectively. However, application of POSSUM and APACHE II predicted a mortality rate of 12 5% for patients in the Group 1 and 11.1% for those in the Group 2 with a predicted morbidity of 25 5% and 25% respectively. [WT5”HZ]Conclusions[WT5”BZ] POSSUM and APACHE II accurately predicts the outcome for patients with pancreatic cancer, and this information could influence the choice of the most appropriate treatment.