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目的:探讨应用POSSUM评分系统评估高龄患者行胰十二指肠切除术(PD)风险的可靠性。方法:将2010年2月—2011年2月间收治的80例行PD患者按照年龄进行分为两组,其中38例≥80岁者为研究组,42例<80岁者作为对照组。分析两组术中、术后情况,比较两组POSSUM评分及POSSUM评分系统对两组并发症发生率与病死率的预测值与实际值间的差异。结果:研究组与对照组比较,手术时间、术中出血量、输血量均无统计学差异(P>0.05),但研究组的住院时间长于对照组(P<0.05)。研究组的POSSUM评分明显高于对照组的POSSUM评分(P<0.05);研究组实际术后并发症发生率和病死率与预测值无统计学差异(P>0.05),而对照组的实际术后并发症发生率和病死率均低于预测值(P<0.05)。结论:采用POSSUM评分系统能够较准确评估高龄患者行PD的手术风险,故对患者围术期管理具有重要的指导意义。
Objective: To evaluate the reliability of the POSSUM scoring system for evaluating the risk of pancreaticoduodenectomy (PD) in elderly patients. Methods: Eighty PD patients who were treated between February 2010 and February 2011 were divided into two groups according to their age. Among them, 38 were over 80 years old as study group and 42 cases were as control group. The two groups were analyzed intraoperatively and postoperatively, and the difference between the predicted and actual rates of the two groups of POSSUM score and POSSUM scoring system was compared. Results: Compared with the control group, there was no significant difference in the operation time, intraoperative blood loss and blood transfusion between the study group and the control group (P> 0.05). However, the length of stay in the study group was longer than that in the control group (P <0.05). The POSSUM score of the study group was significantly higher than that of the control group (P <0.05). There was no significant difference in the actual postoperative complication rate and mortality between the two groups (P> 0.05) Postoperative complication rates and mortality were lower than the predicted values (P <0.05). Conclusion: POSSUM scoring system can accurately evaluate the PD patients in elderly patients with surgical risk, it is of great guiding significance for the perioperative management of patients.