应用APACHEⅡ和POSSUM评分指导胰腺癌患者外科治疗的临床分析.pdfVIP

胰腺外科 应用APACHEⅡ和POSSUM评分指导胰腺 癌患者外科治疗的临床分析 张群华 倪泉兴 张延龄 曹国海 傅德艮 姚琪远 垒忱 虞先浚 张妞 【摘要】 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：LPACHEⅡ评分系统对84侧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( =48)病死率和并发症 分别为6 2％和20 8％，略低于APA帆 Ⅱ和POSSUM评分预测的老年组病死率(12．5％)和并发症 (25 5％)，中青年组病死率(11．1％)和并发症(』％)。 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。POSSUM评分系统更适宜于指导胰腺癌手术的围 手术期处理。 【关键词】胰腺肿瘤；手术：POSSUM；APACHE 1 P(1s!；【】M andAP^C皿EIIfor surgeryin p~ents with paD㈣ 廿c cBDo盯ZH6~G( 血n，M ( ， 三 Yanling， a1．C,wtter Pancrea~ Ctmcer，Huashon／msp／ta／，FuDan Un／vers／ty，酗珊 2OO040， China 【Abs~aa】 Objea~ve To evaluate the physiological and operative ve ty 8cD for enumeaafiOla of thor- tality and morbidity(POSS1351)with Acute physialogy and ehrordc health e,aluation 11(APACHE II) sys- ternfor surgeryinpatientswith pancm．atie 0atlcf,r． Methods The POSSL~I th APACHEⅡsc0 system dur- ． perioperative p,~oain阱 pab口bwith pancreaLi~c r whD had acceptedthe surge~Welt~analysedl~tsO- spectively Results Consecutive series patients who underwent surge~inGmup1(60 years，n=48)or Group 2(60 years， =36)w雌 anatvsed P~toperatK,e complications and 30一 mo~,tlit；,,were record． Inthe G1伽 1，48 patients underwent surge~, th amo~,tlity rate of6 2％ and amorbiditv rate 20．8％ ．In the Group 2．the mortality and morbidity w盯e 5．5％ and 19．4％ respectively．H 岍 盯．application ofPOSSL~I ndKPACHE1I pr~cted nm0枷a rate 12 5％ h D8tientsintheG|o l and 11．I％ rtheeintheGroup 2with a predictedmorbidity of 25．5％ and 25％ respectively． o叩d璐i0璐 P()ssUM and AP^cHEⅡaccu． rarely predicts the outc／lam for咖 棚b with pancr~．atie PAtll~et，and this informafitm could inililek,lc~the choice the most印 )p ate treatment 【gty啊lfk】 Pancreaac neoplasms； Operation： P0ssUM； ．M~AC陋 Ⅱ 随着我国进入老年社会，胰腺癌患者群体年龄