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目的探究计数死亡率和发病率的生理学和手术严重性评分(POSSUM)对住院脊柱外科患者肺部感染的预测价值,以期能为后期临床治疗提供参考。方法选取2014年8月-2016年8月医院收治371例脊柱外科住院患者为研究对象,将年龄<45岁245例患者为低龄组,年龄≥45岁126例患者为高龄组,使用POSSUM评分系统对两组患者肺部感染进行预测。结果低龄组患者手术时间、术中失血量、围手术期输血量和住院天数均显著低于高龄组患者,低龄组患者手术严重性和生理学评分较高龄组患者均低,差异有统计学意义(P<0.05);低龄组患者预测肺部感染率高于高龄组患者,实际肺部感染率低于高龄组患者,且低龄组患者实际肺部感染率显著低于预测肺部感染率,差异有统计学意义(P<0.05),高龄组患者实际与预测肺部感染率差异无统计学意义;低龄组医院感染患者共分离出致病菌15株,高龄组医院感染患者共分离出致病菌9株,两组患者的常见感染病原菌均为大肠埃希菌和粪肠球菌。结论 POSSUM评分能够较好的预测住院脊柱外科患者肺部感染的发生,且对高龄组患者的预测准确度高于低龄组。
Objective To investigate the predictive value of POSSUM for predicting lung infection in hospitalized patients with spine surgery in order to provide reference for clinical treatment in the future. Methods A total of 371 spine surgery inpatients admitted to our hospital from August 2014 to August 2016 were enrolled in this study. A total of 245 patients aged 45 years or younger were enrolled in this study, and 126 patients aged 45 years and older were enrolled in this study. The POSSUM scoring system Pulmonary infections were predicted in both groups. Results The operation time, intraoperative blood loss, perioperative blood transfusion and hospital stay were significantly lower in the younger group than those in the senior group. The severity of the operation and the score of the physiological score in the younger group were lower than those in the senior group (P < P <0.05). In the younger age group, the lung infection rate was higher than that of the elderly group, the actual lung infection rate was lower than that of the elderly group, and the actual lung infection rate of the younger age group was significantly lower than the predicted lung infection rate, the difference was (P <0.05). There was no significant difference between actual and predicted pulmonary infection rates in the advanced age group. 15 pathogenic bacteria were isolated from the nosocomial infection patients in the younger age group, and pathogenic bacteria were isolated from the nosocomial infection patients 9 strains, two groups of patients are common pathogens of Escherichia coli and Enterococcus faecalis. Conclusions The POSSUM score can better predict the pulmonary infection in hospitalized patients with spinal surgery, and the predictive accuracy of the elderly patients is higher than that of the younger patients.