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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 investigate the value of POSSUM score in perioperative monitoring and treatment of patients with colorectal cancer. Methods 96 cases of colorectal cancer were divided into two groups. Group A was not perioperatively evaluated. Only medical experience was used to monitor and treat the patients. The histopathological data were retrospectively scored. The patients in group B received POSSUM score immediately after the operation and guided the treatment . The χ2 test was used to compare the postoperative complications and mortality in the two groups. At the same time, the differences between the actual complications, mortality and the predictive value were compared. Results There was no significant difference between the predicted and actual values of complication rates (34%: 31%, χ2 = 7.16, P = 0.38) and mortality (11% vs 6%, χ2 = 3.06, P = 0.31) (20%) in group B was less than that in group A (40%), the difference was statistically significant (χ2 = 4.41, P = 0.036). Conclusions The POSSUM score can better predict the postoperative complications and death of colorectal cancer. Perioperative treatment under its warning is helpful to reduce postoperative complications.