目的探讨生理学和手术侵袭度评分(Physiological and Operative Severity Score for the enUmeration ofMortality and Morbidity,POSSUM)预测肺癌患者术后并发症发生率和死亡率的应用价值,为临床治疗决策提供参考。方法回顾性分析2007年1月至2010年10月新疆医科大学第一附属医院住院期间接受肺癌手术治疗的179例原发性肺癌患者的临床资料,其中男124例,女55例;年龄(59.2±11.4)岁。术前应用POSSUM评分进行评分,将每位患者评分结果代入POSSUM评分的Copeland方程计算出预测的术后并发症发生率和死亡率。统计179例患者中术后实际并发症例数和死亡例数,将其分为无并发症组和有并发症组,比较两组POSSUM评分情况、并发症与死亡的实际值与预测值。对术后实际并发症和死亡发生的相关临床因素进行单因素分析。结果共有78例患者术后发生并发症,有并发症组生理学评分、手术侵袭度评分均明显高于无并发症组[生理学评分:(16.11±2.53)分vs.(14.88±1.86)分,P=0.000;手术侵袭度评分:(13.47±2.83)分vs.(12.88±2.57)分,P=0.000]。POSSUM评分预测术后并发症65例,实际并发症78例,差异无统计学意义(χ2=1.968,P=0.161)。POSSUM评分预测死亡12例,实际死亡3例,差异有统计学意义(χ2=5.636,P=0.018)。单因素分析结果显示年龄、血红蛋白量、术前肺功能、手术方式和手术时间均与术后并发症的发生相关;其中仅血红蛋白量与术后死亡的发生相关。结论 POSSUM评分能较好地预测肺癌患者术后并发症,但对术后死亡存在过度预测。5个临床观察的单因素具有较好的临床应用价值。 Objective To investigate the application value of Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) in predicting postoperative morbidity and mortality of patients with lung cancer, and to provide reference for clinical treatment decision-making. Methods A retrospective analysis of clinical data of 179 patients with primary lung cancer admitted to the First Affiliated Hospital of Xinjiang Medical University during January 2007 to October 2010 in hospital was performed, including 124 males and 55 females; the age (59.2 ± 11.4) years old. The POSSUM score was applied preoperatively, and the predicted postoperative complication rate and mortality were calculated by applying the Copeland equation of each patient’s score to the POSSUM score. The number of actual complications and death cases in 179 patients were statistically divided into non-complication group and complications group. The POSSUM score, complication and death were compared between the actual value and the predicted value. The postoperative complications and death related clinical factors univariate analysis. Results A total of 78 patients had postoperative complications. Physiological scores and surgical invasiveness scores of patients with complications were significantly higher than those without complications [physiological score (16.11 ± 2.53) vs (14.88 ± 1.86), P = 0.000; surgical invasiveness score: (13.47 ± 2.83) points vs. (12.88 ± 2.57) points, P = 0.000]. POSSUM score predicted 65 cases of postoperative complications, the actual complication in 78 cases, the difference was not statistically significant (χ2 = 1.968, P = 0.161). The POSSUM score predicts 12 deaths and 3 actual deaths, the difference was statistically significant (χ2 = 5.636, P = 0.018). Univariate analysis showed that age, hemoglobin, preoperative pulmonary function, operation method and operation time were all related to postoperative complications; only the amount of hemoglobin was related to the postoperative death. Conclusions The POSSUM score can predict the postoperative complications in patients with lung cancer. However, there is an overestimation of postoperative death. Five clinical observation of single factor has good clinical value.