[1]宋婷婷,王新民,毕希乐,等.老年髋部骨折围术期心力衰竭的危险因素分析[J].中华老年骨科与康复电子杂志,2018,(01):23-28.[doi:10.3877/cma.j.issn.2096-0263.2018.01.006]
　Song Tingting,Wang Xinmin,Bi Xile,et al.Analysis of risk factors of perioperative heart failure in elderly patients with hip fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(01):23-28.[doi:10.3877/cma.j.issn.2096-0263.2018.01.006]
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老年髋部骨折围术期心力衰竭的危险因素分析()
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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:
2018年01期
页码:
23-28
栏目:
髋部骨折合并心力衰竭
出版日期:
2018-01-31

文章信息/Info

Title:
Analysis of risk factors of perioperative heart failure in elderly patients with hip fracture
作者:
宋婷婷1; 王新民2; 毕希乐1; 国强华1; 贾红丹1; 崔蕊1; 刘丽1
066000 秦皇岛市第一医院心血管内科1，骨科2
Author(s):
Song Tingting1;  Wang Xinmin2;  Bi Xile1;  Guo Qianghua1;  Jia Hongdan1;  Cui Rui1;  Liu Li1
1Department of Cardiology, 2Department of Orthopaedics, First hospital of Qin huangdao, Qin huangdao 066000, China
关键词:
老年人;  髋骨折;  围手术期;  心力衰竭
Keywords:
Aged;  Hip fractures;  Perioperative period;  Heart failure
DOI:
10.3877/cma.j.issn.2096-0263.2018.01.006
文献标志码:
A
摘要:
目的 探讨老年髋部骨折患者围手术期发生心力衰竭的相关危险因素。方法 回顾性分析2010年10月至2017年1月因髋部骨折于秦皇岛市第一医院住院治疗的225例患者，其中心衰组64例、非心衰组161例，记录并比较两组患者的基本情况、相关检查结果及术中、术后管理因素等，采用多因素Logistic回归分析老年髋部骨折围手术期发生心力衰竭的相关危险因素。结果 心衰组与非心衰组在年龄、收缩压、入院至手术时间、ASA分级、系统疾病数超过4种、合并心血管疾病、低血红蛋白量、手术方式、输血量≥400 ml、术中补液量大、每日液体出入量差值大、输注血白蛋白、术后电解质紊乱等方面具有统计学差异（c2=19.861，c2=7.075，c2=8.732，c2=25.504，c2=29.226，c2=45.825，c2=14.362，c2=6.662，c2=8.190，c2=7.216，c2=30.086，c2=10.122，c2=12.079，均P＜0.05）。Logistic回归分析示系统疾病数超过4种、合并心血管疾病、低血红蛋白量、电解质紊乱、围手术期液体“正平衡”、ASA分级Ⅱ级以上为老年髋部骨折患者围手术期发生心力衰竭的独立危险因素（OR：5.769，95% CI：1.212～36.243；OR：9.576，95% CI：2.118～45.387；OR：3.686，95% CI：1.313～10.349；OR：6.584，95% CI：1.217～26.744；OR：14.114，95% CI：5.021～42.342；OR：6.012，95% CI：3.245～11.329）。结论 老年髋部骨折围手术期发生心力衰竭是由多种因素共同作用的结果，围手术期准确的风险评估、早期治疗合并症、减少手术创伤以及完善术后补液是减少此类患者发生心力衰竭的关键。
Abstract:
Objective To analyze risk factors of the perioperative heart failure following hip fracture surgery in the aged patients and put forward prevention countermeasures so as to reduce the mortality rate for clinical work. Methods The present study included 225 elderly patients who had received hip fracture surgeries from October 2010 to January 2017 in our hospital. Patients were divided into heart failure group (64 cases) and non-heart failure group (161 cases). Single factor analysis was performed in three aspects as preoperative basic situation, preoperative examination and surgical management, the dominant risk factors then rolled into logistic regression analysis to conclude the dependent risk factors of perioperative heart failure. Results Age, systolic blood pressure, delay from admission to operation, ASA classification, numbers of systemic diseases (expect cardiovascular disease), cardiovascular disease, low hemoglobin volume, operative management, blood transfusion ≥400 ml, intraoperative fluid volume, daily liquid volume difference and infusion of human serum albumin were risk factors for perioperative heart failure in elderly hip fractures (c2=19.861, c2=7.075, c2=8.732, c2=25.504, c2=29.226, c2=45.825, c2=14.362, c2=6.662, c2=8.190, c2=7.216, c2=30.086, c2=10.122, c2=12.079, P<0.05). The logistic regression analysis showed that combined with more than 4 underlying diseases, cardiovascular disease, anemia, electrolyte imbalance, perioperative fluid intake, ASA classification were independent risk factors for perioperative heart failure (OR: 5.769, 95% CI: 1.212-36.243; OR: 9.576, 95% CI: 2.118-45.387; OR: 3.686, 95% CI: 1.313-10.349; OR: 6.584, 95% CI: 1.217-26.744; OR: 14.114, 95% CI: 5.021-42.342；OR: 6.012, 95% CI: 3.245-11.329). Conclusions Perioperative heart failure in hip fracture is the result of combination of multiple factors, perioperative risk assessment, early treatment for complications, surgical trauma reduction and postoperative fluid rehydration are the key to reduce perioperative heart failure.

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备注/Memo

备注/Memo:
基金项目：河北省2017年度医学科学研究重点课题计划（20171253）
更新日期/Last Update: 2018-01-31