摘要
目的探讨美国麻醉医师协会(ASA)分级在老年肝癌患者外科治疗风险评估中的临床价值。方法回顾性分析2004年1月至2012年4月期间我院收治且经病理检查确诊的老年肝癌患者556例,根据术后住院期间并发症发生情况分为并发症组和无并发症组。对2组患者临床病理指标和手术情况进行比较,并对相关风险因素进行多因素回归分析。结果多因素分析显示ASA分级(OR=2.228,P<0.01)、年龄(OR=1.582,P=0.034)、输红细胞(OR=2.277,P<0.01)和肝硬化(OR=1.910,P=0.01)是老年肝癌患者术后并发症发生的独立影响因素。ASA分级、Child-Pugh(CTP)分级和终末期肝病模型(MELD)评分的受试者工作曲线(ROC)下面积分别为0.637(P<0.01),0.605(P<0.01),0.558(P=0.076)。结论在老年肝癌肝切除手术中ASA分级可以作为早期预测的指标来帮助外科医生评估围手术期风险。
Objective To assess the value of ASA grade in risk estimation for the elderly patients with liver cancer.Methods 556 elderly patients diagnosed definitely as liver cancer were enrolled from January 2004 to April 2012 in our hospital. The patients were divided into the complication group and non-complication group according to the occurrence of postoperative complications during hospital day. Furthermore,operative parameters of patients were compared in two groups,and independent impact factors for postoperative complications were identified by multiple regression analysis.Results ASA grade was related to postoperative complications,patients with a higher ASA grade had a more risk of postoperative complications. The age（ OR = 1. 582,P = 0. 034）,red blood cell transfusion（ OR = 2. 277,P 〈 0. 01）,ASA grade（ OR = 2. 228,P 〈 0. 01） and liver cirrhosis（ OR = 1. 910,P = 0. 01） and liver cirrhosis were the independent impact factors for postoperative complications by multivariate regression analysis. Receiver operating characteristic curves showed that ASA grade was superior to CTP and MELD in predicting postoperative outcomes. Conclusions ASA grade is a better index for early estimation of the perioperative risk for the elderly patients with cancer.
出处
《实用老年医学》
CAS
2015年第9期755-758,共4页
Practical Geriatrics
关键词
美国麻醉医师协会分级
肝癌
围手术期
老年人
American Society of Anesthesiologists physical status classification
liver cancer
perioperative
aged
