【摘要】 目的　探讨动态APACHEⅡ评分和POSSUM评分在重症急性胰腺炎治疗中联合应用的价值。方法　 1995～ 2 0 0 2年对 4 3例重症急性胰腺炎病人每日进行APACHEⅡ评分 ,均先予非手术治疗 ,如评分下降 ,继续支持治疗 ,如评分进行性上升 ,考虑有感染性坏死、腹腔内出血、胃肠道穿孔原因时急诊手术。每次手术后均进行POSSUM评分 ,并计算术后并发症发生概率和死亡发生概率。结果　根据动态评分结果 ,16例采用非手术治疗 ,16例单次手术 ,11例多次手术。结论　动态APACHEⅡ评分能较好判断手术时机 ,POSSUM评分能较好地预测术后并发症、死亡的发生 ,并能对需再次手术病例起较好的预警作用。更多还原

【Abstract】 Objective To discuss the value of combining the physiological and operative severity score for enumeration of mortality and morbidity(POSSUM)with acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score in severe acute pancreatitis. Methods APACHEⅡ score in 43 patients of severe acute pancreatitis were recorded prospectively everyday.All were first treated by nonoperative treatment until APACHEⅡ score ascend.If there were necrosis or haemorrhage,they would be operated.POSSUM scoring was performed after operation,and the risk of morbidity and mortality was calculated in all operated patients. Results Sixteen cases were treated by nonoperative treatment,16 cases by only once operation and 11 cases by many times of operations. Conclusion Dynamic APACHEⅡ score can estimate the suitable occasion of operation.The POSSUM score allows satisfactory prediction of mortality and morbidity in patients having received surgery,and satisfactory warning for patients who would be operated again.更多还原