| 常雪南 董冉 孙家晓 叶红 李恩有.心脏手术风险评估欧洲系统在OPCAB术后ICU中的应用[J].,2015,15(4):774-776 |
| 心脏手术风险评估欧洲系统在OPCAB术后ICU中的应用 |
| The Application of European Systemfor Cardiac Operative RiskEvaluation after OPCAB in ICU |
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| DOI： |
| 中文关键词: 心脏手术风险评估欧洲系统 冠状动脉旁路移植术 重症监护室 |
| 英文关键词: EuroSCORE OPCAB ICU |
| 基金项目: |
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| 中文摘要: |
| 现在对于不停跳冠脉旁路移植术（OPCAB）的患者术后的预测的模型有很多种，这些模型大多用于预测术后死亡率、术后并
发症，手术方式的选择、手术资源的应用价值的评估等。心脏手术风险评估欧洲系统（EuroSCORE）也是其中一种，它对于现代
OPCAB术后死亡率的预测比较合理。但是随着手术外科的发展，EuroSCORE 模型在中、低危组过高估计术后的死亡率，而在高危
组又过低估计术后死亡率。此外，EuroSCORE模型也应用于预测术后并发症、住院费用多少、在ICU住院时间及机械通气时间，
得到广泛应用，并在世界范围内得到推广，包括欧美等国家。最近在中国，也开始对心脏手术风险评估欧洲系统大量了的数据研
究，并发展到对其他手术术后的预测及治疗。 |
| 英文摘要: |
| Nowadays, the prediction of patients' outcomes after off-pump coronary artery bypass graft (OPCABG) has been assessed
by many risk stratification models. These models are useful in predicting postoperative motality and morbidity, assessing surgical
methods decision making, estimating the need for resources. The European System for Cardiac Operative Risk Evaluation (EuroSCORE)
is one of them, it is a reasonable predictor for OPCAB. However, with the development of the external surgery, the EuroSCORE model
over estimates observed mortality in the low risk group and underestimates observed mortality in the high-risk group. The model was developed
on data in the late 1990s and surgical practice has changed since then with increasing numbers of patients with coronary disease
treated percutaneously. Advances in surgery, anaesthetic and intensive care have led to overall reductions in surgical mortality, despite
higher predicted operative mortality. In addition, the EuroSCORE model also can be used in the prediction of patients' postoperative complications,
assessing the cost of hospitalization, estimating the time of ICU and duration of mechanical ventilation. The EuroSCORE
should be recalibrated before it is used to gain reassurance about outcomes. Caution should be exercised when using it to compare hospitals
or surgeons with a different operative case mix. Incidentally, the EuroSCORE model is used widly in the world and be promoted
worldwide. Recently, there are a large mumber of data about the EuroSCORE model in China, and also it has been used in other fields,
such as postoperative theatment and forecasts in addition to OPCAB. EuroSCORE and a prolonged intensive care stay after surgery are
associated with long termevent-free survival and can be used to tailor long term postoperative follow-up and plan resource allocation for
the cardiac surgical patient. In conclusion, EuroSCORE can predict mortality, certain major postoperative complications, and postoperative
recovery in those who undergo not only on-pump but also off-pump CABG. |
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