| 摘要: |
| ［摘要］ 目的 探讨改良POSSUM（Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity）评分在预测肺癌患者胸腔镜术后并发症发生率中的应用价值。方法 收集2016-01～2018-12在石河子大学医学院第一附属医院接受胸腔镜手术治疗的142例肺癌患者的临床资料，采用二元Logistic回归分析各指标对术后并发症发生率的影响，剔除POSSUM评分中不适用于肺部手术的指标，纳入筛选出的指标制成改良POSSUM评分系统。结果 142例患者中共有34例（23.9%）患者出现术后并发症。Logistic回归分析显示年龄（OR=2.699，95%CI=1.121～6.496）、心脏征象（OR=3.375，95%CI=1.513～7.526）、呼吸系统征象（OR=2.420，95%CI=1.050～5.579）、脉率（OR=2.600，95%CI=1.176～5.747）、手术范围（OR=1.350，95%CI=1.056～1.725）、失血量（OR=3.211，95%CI=1.290～7.993）、体质量指数（body mass index,BMI）（OR=1.199，95%CI=1.026～1.400）、第1秒用力呼气容积占用力肺活量百分比［the forced expiratory volume in 1 sencond(FEV1)/forced vital capactity(FCV) ratio(%),FEV1/FVC(%)］（OR=2.965，95%CI=1.203～7.308）、手术时间（OR=2.518，95%CI=1.117～5.672）为影响术后并发症的独立因素（P<0.05）。改良POSSUM评分系统受试者工作特征（ROC）曲线下面积（AUC）为（0.710±0.051）［95%CI（0.628～0.783）］，标准POSSUM评分系统AUC为（0.649±0.055）［95%CI（0.565～0.727）］，差异有统计学意义（P<0.05）。结论 改良POSSUM评分对肺癌患者胸腔镜术后并发症发生率具有较好的预测价值，可为临床医师提供术前决策依据。 |
| 关键词: 肺癌 电视辅助胸腔镜手术 POSSUM评分系统 并发症 |
| DOI：10.3969/j.issn.1674-3806.2020.07.12 |
| 分类号:R 619.5 |
| 基金项目: |
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| Predictive value of modified POSSUM in the incidence of complications after thoracoscopic surgery in lung cancer patients |
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ZUO Yan-song, HOU Liang, YIN Lai-bo, et al.
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The First Department of Cardiothoracic Surgery, the First Affiliated Hospital of Shihezi University School of Medicine, Xinjiang Uygur Autonomous Region 832000, China
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| Abstract: |
| ［Abstract］ Objective To investigate the application value of modified Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity(POSSUM) in predicting the incidence of complications after thoracoscopic lung cancer surgery. Methods The clinical data of 142 lung cancer patients who underwent video-assisted thoracic surgery(VATS) at the First Affiliated Hospital of Shihezi University School of Medicine from January 2016 to December 2018 were collected. The effect of each index on the incidence of postoperative complications was analyzed using binary Logistic regression. The modified POSSUM scoring system was made by excluding the indexes that were not suitable for lung surgery from the standard POSSUM scoring system and including in the selected indexes. Results Of the 142 patients, 34 patients(23.9%) occurred postoperative complications. Logistic regression analysis showed that age(OR=2.699, 95%CI=1.121～6.496), signs of the heart(OR=3.375, 95%CI=1.513～7.526), signs of the respiratory system(OR=2.420, 95%CI=1.050～5.579), pulse rate(OR=2.600, 95%CI=1.176～5.747), scope of surgery(OR=1.350, 95%CI=1.056～1.725), volume of blood loss(OR=3.211, 95%CI=1.290～7.993), body mass index(BMI)(OR=1.199, 95%CI=1.026～1.400), the forced expiratory volume in 1 sencond(FEV1)/forced vital capactity(FCV) ratio(%)［FEV1/FVC(%)］(OR=2.965, 95%CI=1.203～7.308) and time of operation(OR=2.518, 95%CI=1.117～5.672) were the independent risk factors for postoperative complications(P<0.05). The receiver operating chacracteristic(ROC) area under the curve(AUC) of the modified POSSUM scoring system was (0.710±0.051)［95%CI(0.628～0.783)］, and that of the standard POSSUM scoring system was (0.649±0.055)［95%CI(0.565～0.727)］, with a statistically significant difference(P<0.05). Conclusion The modified POSSUM has a good predictive value for the occurrence of postoperative complications in lung cancer patients after thoracoscopic surgery, and can provide the clinicians with the basis for preoperative decision making. |
| Key words: Lung cancer Video-assisted thoracic surgery(VATS) Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity(POSSUM) scoring system Complications |
