一种基于大宗病例的预测腹腔镜胃癌术后并发症发生风险的评分系统
发布时间：2019-04-19 10:59
【摘要】：目的探讨腹腔镜胃癌根治术后并发症的发生情况及其影响因素,并建立一种新的预测并发症发生风险的评分系统。方法前瞻性收集回顾性分析2007年5月至2013年12月间我科施行的2170例腹腔镜胃癌根治术患者的临床病理特征(性别、年龄、体重指数(BMI)、腹部手术史、Charlson合并症指数、血色素、白蛋白、每分最大通气量、肿瘤合并幽门梗阻、肿瘤合并出血、肿瘤部位、肿瘤大小、肿瘤浸润深度、淋巴结转移、肿瘤分期)、手术情况(手术时间、术中失血量、手术类型、重建方式、D1+/D2清扫、淋巴结清扫数目、手术年份)及术后并发症发生情况,并根据并发症的危险因素建立评分系统。结果全组2170例患者中,发生并发症患者299例,发生率为13.8%;严重并发症患者78例,发生率为3.6%。多因素分析表明年龄≥65岁、BMI≥28 kg/m2、肿瘤合并幽门梗阻、肿瘤合并出血和术中失血量≥75ml是总体并发症发生的独立危险因素;年龄≥65岁、Charlson合并症指数≥3分、肿瘤合并出血和术中失血量≥75ml是严重并发症发生的独立危险因素。分别根据独立危险因素,建立评分系统:低危组(0分,无危险因素),中危组(1分,1个危险因素),高危组(≥2分,≥2个危险因素)。低危、中危、高危三组中,总体并发症发生率分别为8.3%、15.6%和29.9%(p0.001);严重并发症发生率分别为1.2%、4.7%和10.0%(p0.001)。总体并发症的Logistic回归模型和评分系统预测模型的AUC分别为0.641(95%CI:0.606-0.675)和0.637(95%CI:0.602-0.671)。严重并发症的Logistic回归模型和评分系统预测模型的AUC分别为0.715(95%CI:0.658-0.772)和0.707(95%CI:0.650-0.764)。结论根据并发症危险因素构建的评分系统能够简单有效的预测术后并发症的发生风险。该评分系统有助于选择与风险相适应的围术期干预措施,提高手术安全性。
[Abstract]:Objective to investigate the incidence and influencing factors of complications after laparoscopic radical gastrectomy (LGC) and to establish a new scoring system for predicting the risk of complications. Methods from May 2007 to December 2013, the clinicopathological features (sex, age, body mass index (BMI), (BMI), abdominal surgery history, Charlson complication index) of 2170 patients undergoing laparoscopic radical gastrectomy in our department were analyzed prospectively and retrospectively. Hemochrome, albumin, maximum ventilation per minute, tumor with pyloric obstruction, tumor with bleeding, tumor location, tumor size, depth of tumor invasion, lymph node metastasis, tumor stage), operative conditions (operation time, intraoperative blood loss, tumor site, tumor size, depth of tumor invasion, lymph node metastasis, tumor stage), operation status (operation time, intraoperative blood loss, Type of operation, reconstruction mode, D1 / D2 dissection, number of lymph node dissection, year of operation) and postoperative complications. The scoring system was established according to the risk factors of complications. Results among the 2170 patients, 9 9 cases (13.8%) had complications and 78 cases (3.6%) had severe complications. Multivariate analysis showed that age 鈮，
本文编号：2460879
[Abstract]:Objective to investigate the incidence and influencing factors of complications after laparoscopic radical gastrectomy (LGC) and to establish a new scoring system for predicting the risk of complications. Methods from May 2007 to December 2013, the clinicopathological features (sex, age, body mass index (BMI), (BMI), abdominal surgery history, Charlson complication index) of 2170 patients undergoing laparoscopic radical gastrectomy in our department were analyzed prospectively and retrospectively. Hemochrome, albumin, maximum ventilation per minute, tumor with pyloric obstruction, tumor with bleeding, tumor location, tumor size, depth of tumor invasion, lymph node metastasis, tumor stage), operative conditions (operation time, intraoperative blood loss, tumor site, tumor size, depth of tumor invasion, lymph node metastasis, tumor stage), operation status (operation time, intraoperative blood loss, Type of operation, reconstruction mode, D1 / D2 dissection, number of lymph node dissection, year of operation) and postoperative complications. The scoring system was established according to the risk factors of complications. Results among the 2170 patients, 9 9 cases (13.8%) had complications and 78 cases (3.6%) had severe complications. Multivariate analysis showed that age 鈮，
本文编号：2460879
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