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目的采用生理能力与手术侵袭度评分系统(E-PASS)预测结直肠癌患者择期手术风险,探讨其在术后并发症风险预测中的临床应用价值。方法回顾性分析313例结直肠癌患者使用E-PASS评分系统评估其手术风险,比较E-PASS中的术前风险分数(PRS)、手术侵袭度分数(SSS)和综合风险分数(CRS)评分与实际手术预后的关系,并探讨E-PASS各项指标与术后风险的关系。结果纳入分析的患者中,有22例(7.0%)患者发生术后并发症。患者的年龄(P=0.003)、体重(P=0.019)、肿瘤组织学类型(P=0.033)、Dukes分期(P=0.001)、严重心脏疾病(P=0.019)、严重肺部疾病(P=0.000)、体能状态指数(P=0.000)、失血量/体重(P=0.007)、失血量(P=0.001)和手术时间(P=0.000)均与并发症的发生相关;肿瘤分化程度(P=0.503)、糖尿病(P=0.745)、ASA分级(P=0.085)和手术切口大小(P=0.726)与并发症的发生无关。有并发症组的PRS和CRS明显高于无并发症组(P<0.001),而SSS在2组间的差异无统计学意义(P=0.059)。结论 E-PASS评分系统是一个相对方便、有效和易操作的手术风险评估系统,能够较准确地预测结直肠癌患者术后短期并发症的发生。
Objective To evaluate the clinical value of E-PASS in predicting the surgical risk of patients with colorectal cancer, and to explore the clinical value of E-PASS in predicting the risk of postoperative complications. Methods Retrospective analysis of 313 cases of colorectal cancer patients using E-PASS scoring system to assess the surgical risk, compared with the E-PASS preoperative risk score (PRS), surgical invasiveness score (SSS) and comprehensive risk score (CRS) And the actual surgical prognosis, and to explore the E-PASS indicators and postoperative risk. Results Of the patients included in the analysis, 22 (7.0%) patients had postoperative complications. The patient’s age (P = 0.003), body weight (P = 0.019), tumor histological type (P = 0.033), Dukes stage (P = 0.001), severe heart disease (P = 0.019), severe lung disease (P = 0.000), physical status index (P = 0.000), blood loss / body weight (P = 0.007), blood loss (P = 0.001) and operation time (P = 0.000) = 0.503). Diabetes (P = 0.745), ASA grade (P = 0.085) and surgical incision size (P = 0.726) were not associated with complications. PRS and CRS in patients with complications were significantly higher than those without complications (P <0.001), while there was no significant difference in SSS between the two groups (P = 0.059). Conclusion E-PASS scoring system is a relatively convenient, effective and easy-to-operate surgical risk assessment system, which can predict the short-term complications of patients with colorectal cancer more accurately.