POSSUM评分系统预测高龄患者胰十二指肠切除术风险的价值

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。

Value of POSSUM scoring system for risk estimation in elderly patients undergoing pancreaticoduodenectomy

Objective: To evaluate the reliability of using POSSUM scoring system for risk estimation in elderly patients undergoing pancreaticoduodenectomy (PD). Methods: Eighty patients undergoing PD between February 2011 and February 2010 were divided into two groups according to their ages. Of the patients, 38 cases ≥80 year old were allocated to observational group, and the other 42 cases >80 years old served as control group. The intra- and postoperative conditions of the two groups of patients were analyzed, and the POSSUM scores between the two groups as well as the difference between the POSSUM predicted and actual incidence of complications and mortality in the two groups were compared. Results: In observational group, the operative time, intraoperative blood loss and blood infusion requirement showed no significant difference versus control group (all P>0.05), but length of hospital stay was longer than that of control group (P<0.05). The POSSUM score in observational group was significantly higher than that in the control group (P<0.05); there was no significant difference between the predicted and actual incidence of complications and mortality in observational group (P>0.05), but both actual incidence of complications and mortality were significantly lower than those of predicted values in control group (P<0.05). Conclusion: Application of POSSUM scoring system can provide a relatively accurate estimation of the surgical risk in elderly patients undergoing PD, so it has guiding significance for these patients in perioperative management.