[1]陈述祥,刘彦,区文欢,等.老年髋部骨折术后肺部并发症的危险因素分析[J].中华老年骨科与康复电子杂志,2016,(04):239-244.[doi:10.3877/cma.j.issn.2096-0263.2016.04.009]
　Chen Shuxiang,Liu Yan,Ou Wenhuan,et al.Risk factor analysis for postoperative pulmonary complications in elderly hip fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):239-244.[doi:10.3877/cma.j.issn.2096-0263.2016.04.009]
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老年髋部骨折术后肺部并发症的危险因素分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年04期
页码:
239-244
栏目:
围术期管理
出版日期:
2016-11-05

文章信息/Info

Title:
Risk factor analysis for postoperative pulmonary complications in elderly hip fractures
作者:
陈述祥 1; 刘彦 1; 区文欢 1; 陈丽君 2
529031 江门，暨南大学附属江门中医院（广东省江门市五邑中医院）骨伤科二区 1，康复科 2
Author(s):
Chen Shuxiang1;  Liu Yan1;  Ou Wenhuan1;  Chen Lijun2
1The Second Department of Orthopedic, 2Rehabilitation Department, the Jiangmen TCM Affiliated Hospital of JI’nan University (Wuyi TCM Hospital of Jiangmen Guangdong), Jiangmen 529031, China
关键词:
老年人;  髋骨折;  肺功能测定;  血气分析;  术后并发症
Keywords:
Aged;  Hip fractures;  Respiratory function tests;  Blood gas analysis;  Postoperative complications
DOI:
10.3877/cma.j.issn.2096-0263.2016.04.009
文献标志码:
A
摘要:
目的 探讨引起老年髋部骨折患者术后肺部并发症（PPC）的危险因素。方法 回顾性分析广东省江门市五邑中医院骨伤科二区在 2012年 6月至 2015年 6月收治的符合纳入标准的老年髋部骨折患者 418例，其中男性 182例（43.5%），女性 236例（56.5%），年龄 75～99岁，平均（82±6）岁，根据是否出现 PPC进行分组，记录并比较两组患者的年龄、性别、手术方式、麻醉方式、术前并存病、待术时间、血气分析和肺通气功能情况，采用多因素logistic回归分析老年髋部骨折术后并发症的相关危险因素。结果单因素分析示组间年龄（c2=12.473，P=0.001）、麻醉方式（c2=36.721，P＜0.001）、术前并存病（c2=16.724， P＜0.001）、待术时间（t=4.872，P=0.041）、血气分析（c2=26.341，P＜0.001）、肺通气功能（c2=35.431， P＜0.001）差异有统计学意义。多因素 Logistic回归分析示年龄＞85岁组 PPC发生率高于年龄＜85岁组，OR 值为 3.673（95% CI：1.684，7.615）；待术 3～4 d 组和 5～7 d 组和 PPC 发生率高于 1～2 d 组（OR： 13.349，95% CI：5.391～23. 819；OR：16.579，95% CI：6.324～37.324）；术前并存病≥3组 PPC的发生率高于≤2 组（OR：4.069，95% CI：2.024～8.182）；全麻 组 PPC 发 生 率 高 于 椎 管 内 麻 醉 组（OR：3.579， 95% CI：1.848～8.608）；血气分析异常组 PPC 发生率高于血气分析正常组（OR：9.842，95% CI： 2.338～7.421）；肺 通 气 功 能 异 常 组 PPC 发 生 率 高 于 肺 通 气 功 能 正 常 组（OR：11.384，95% CI： 3.652～9.352）。结论 高龄、术前并存病≥3种、待术时间长、全身麻醉以及血气分析异常和肺通气功能异常是老年髋部骨折患者发生 PPC的危险因素。
Abstract:
Objective To evaluate the risk factors of postoperative pulmonary complications in elderly hip fracture patients. Methods Four hundred and eighteen hip fracture patients treated in the second department of orthopaedic Wuyi TCM Hospital of Jiangmen Guangdong from June 2012 to June 2015 were included in this retrospective study. There were 182 males, 236 females with an average of 82 ± 6 years (range, 75-99 years). Patients were divided into non-PPC and PPC group. Age, gender, surgery approach, anesthesia method, preoperative comorbidity, time interval from injury, blood gas analysis, pulmonary ventilation function were compared between two groups, Mutil- factor logistic regression analysis was applied to investigate risk factors of postoperative pulmonary complications in elderly hip fractures. Results There was significant difference on age (c2=12.473, P=0.001), anesthesia method (c2=36.721, P<0.001), preoperative comorbidity (c2=16.724, P<0.001), time interval from injury (t=4.872, P=0.041), the blood gas analysis (c2=26.341, P<0.001), pulmonary ventilation function (c2=35.431, P<0.001) using single factor analysis. Multi-factor Logistic regression analysis showed that PPC occurrence rate in patients over 85 years was higher than that in patients under 85 years, and the OR value was 3.673 (95%CI: 1.684-7.615). Rate of PPC occurrence in 3-4 d group and 5-7 d group from injury was both higher than that in 1-2 d group, OR value was 13.349 (95% CI: 5.391-23.819) and 16.579 (95% CI: 6.324-37.324). Incidence of PPC in more than 2 preoperative comorbidities group was higher than that in less than 3 preoperative comorbidities group, OR value was 4.069 (95% CI: 2.024-8.182). Generalanesthesia group was higher than the intraspinal anesthesia group, OR value was 3.579 (95% CI: 1.848-8.608). The blood gas analysis show that the PPC occurrence rate in the abnormal group was higher than the normal group, OR value was 9.842 (95% CI: 2.338-7.421); PPC occurrence rate in the abnormal Pulmonary ventilation function group was higher than the normal one, OR value was 11.384 (95% CI: 3.652-9.352). Conclusion Advanced age, more preoperative comorbidity, prolonged time interval from injury, general anesthesia, abnormal blood gas analysis and abnormal pulmonary ventilation function are the risk factors for PPC in elderly patients with hip fracture.

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备注/Memo

备注/Memo:
基金项目：江门市科技计划（【2014】73-6号）
更新日期/Last Update: 2017-04-01