改良POSSUM评分预测甲状腺癌患者术后并发症发生率的价值-肿瘤学专业论文.docx

— — PAGE 1— 摘 要 改良 POSSUM 评分预测甲状腺癌患者术后 并发症发生率的价值 研究生：付明刚 指导老师：马斌林教授 摘 要 目的：分析改良生理学和手术严重性评分系统(POSSUM 评分系统)预测甲状腺 癌患者术后并发症发生率的应用价值。方法：对 2007 年 1 月～2007 年 11 月新疆医 科大学附属肿瘤医院头颈外科 150 例甲状腺癌患者术后并发症情况作回顾性分析， 用改良 POSSUM 评分系统（将肺部感染纳入肺部评价指标，心电图评分细化，手 术严重性指标中将腹腔污染改为术野情况，手术严重性根据甲状腺外科情况分 4 级） 进行评分。按 Copeland 并发症发生率计算公式，比较实际并发症发病人数与预测发 病数。结果：用改良 POSSUM 评分预测并发症人数（48 例），与实际并发症人数 （43 例）之间差异无统计学意义(P 0.05) 。无并发症组在生理学评分和手术侵袭 度评分上均低于并发症组，差异有统计学意义( P 0.05) 。结论：改良 POSSUM 评 分系统可正确评价甲状腺癌手术预后。根据评分结果可指导围手术期加强监测及器 官支持治疗，有助于减少并发症的发生。 关键词：甲状腺癌；POSSUM 评分；术后并发症 新疆医科大学医学硕士学位论文 Value Of Modified POSSUM For Postoperative Morbidity Risk In Thyroid Carcinoma Patients Postgraduate:FuMinggang Supervisor: Prof. MaBinglin Abstract Objective: To analysis the modified POSSUM surgical scoring system in predicting the postoperative morbidity in patients with thyroid carcinoma. Methods: 150 patients with thyroid carcinoma in head and neck surgery of tumor affiliated hospital of xinjiang medical university from january 2007 to november 2007 were retrospectively analyzed with modified POSSUM surgical scoring system. In the modified POSSUM, Lung infection were included into the evaluation of lung and ECG were evaluated more detailed; Abdominal cavity soiling were replaced by surgical field condition, the operative severity scores were classified 4 grades.A comparison between the observed and the predicted morbidity was made. Results:48 patients with complication were predicated by the modified POSSUM surgical scoring system. There was no significant difference between 48 predicated and 43 observed morbidity (P0.05). score of physiology and score of operative severity in the group without complication were lower than those in the groups with complications (P0.05). Conclusion: The modified POSSUM surgical scoring system can evaluate and predict the prognosis of the patients with thyroid carcinoma. Intensive monitoring and organ supporting therapy during the operation according to the score is of great benefit to decr