我院老年股骨粗隆间骨折患者生存相关因素分析

发布时间：2018-02-16 12:57

本文关键词： 股骨粗隆间骨折老年人危险因素死亡率　出处：《广州中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨影响老年股骨粗隆间骨折患者生存的因素,为提高老年股骨粗隆间骨折患者生存率及生存质量提供临床依据。方法：回顾性分析2012年3月至2013年3月于我院住院治疗的174例老年股骨粗隆间骨折患者,其中152例获得随访并纳入研究。对患者年龄、性别、生理学指标、骨折类型、伤前合并症数量及类型、ASA评级、POSSUM生理学评分、Hb、ALB、手术时机、手术方式、手术时间、麻醉方式、围手术期输血情况、伤后并发症、抗骨质疏松治疗等因素先进行单因素分析,对有统计学意义的变量再进行多因素Logistic回归分析,判断该因素是否为影响老年股骨粗隆间骨折患者死亡的独立危险因素。结果：对于老年股骨粗隆间骨折患者,年龄、性别、血清白蛋白、血红蛋白、ASA评级、POSSUM生理学评分、伤前合并症的数量、伤前合并心脏疾病、合并呼吸系统疾病、治疗方式、呼吸系统并发症、消化系统并发症及心血管系统并发症是其1年死亡的影响因素。通过多元回归分析后得出,心血管系统并发症及呼吸系统并发症,是老年股骨粗隆间骨折患者1年死亡的独立危险因素。对于老年股骨粗隆间骨折手术患者,年龄、血清白蛋白、ASA评级、POSSUM生理学评分、伤前合并症的数量、伤前合并心脏疾病、合并呼吸系统疾病、术后发生呼吸系统并发症及心血管系统并发症是术后1年死亡的影响因素。通过多元回归分析后得出,术后呼吸系统并发症及心血管系统并发症,是老年股骨粗隆间骨折患者1年内死亡的独立危险因素。结论：呼吸系统并发症及心血管系统并发症是老年股骨粗隆间骨折患者及手术患者1年死亡的独立危险因素。白蛋白、血红蛋白、ASA评级、POSSUM生理学评分、治疗方式、伤前合并病数量、心脏疾病或呼吸系统合并症对患者死亡率有影响。因此,加强对老年股骨粗隆间骨折患者内科情况的了解,对患者全身状况作充分评估,改善患者营养情况及内科病情况,预防心血管系统、呼吸系统并发症发生,有利于提高患者的生存率。
[Abstract]:Objective:. To explore the factors affecting the survival of elderly patients with intertrochanteric fracture of femur, and to provide clinical basis for improving the survival rate and quality of life of elderly patients with intertrochanteric fracture of femur. Methods:. A retrospective analysis was made on 174 elderly patients with intertrochanteric fracture of femur who were hospitalized in our hospital from March 2012 to March 2013. 152 of them were followed up and included in the study. The number and type of complications before injury were assessed by ASA and POSSUM physiological score. The time of operation, operation method, operation time, anesthetic method, perioperative blood transfusion, post injury complications, anti-osteoporosis treatment and so on were analyzed by univariate analysis. Multivariate Logistic regression analysis was performed to determine whether this factor was an independent risk factor for the death of elderly patients with intertrochanteric fracture of femur. Results:. For elderly patients with intertrochanteric fracture of femur, age, sex, serum albumin, hemoglobin ASA rating and possum physiological score, the number of preinjury complications, pre-injury complicated heart diseases, respiratory diseases, treatment methods, The complications of respiratory system, digestive system and cardiovascular system were the influencing factors of 1-year mortality. The results of multiple regression analysis showed that the complications of cardiovascular system and respiratory system, It is an independent risk factor for 1-year death in elderly patients with intertrochanteric fracture. For elderly patients with intertrochanteric fracture of femur, age, serum albumin ASA rating and possum physiological score, the number of complications prior to injury, preinjury associated with heart disease, and respiratory diseases, Complications of respiratory system and cardiovascular system were the influencing factors of postoperative mortality in one year after operation. The results of multiple regression analysis showed that the complications of respiratory system and cardiovascular system after operation. It is an independent risk factor of death in elderly patients with intertrochanteric fracture within 1 year. Conclusion:. Complications of respiratory system and cardiovascular system were independent risk factors for 1 year death in elderly patients with intertrochanteric fracture and operation. Heart disease or respiratory complications have an impact on mortality. Therefore, to strengthen the understanding of the medical situation of the elderly patients with intertrochanteric fracture, to make a full assessment of the patients' general condition, to improve the nutritional status and internal medical condition of the patients, to prevent the occurrence of cardiovascular system and respiratory complications, It can improve the survival rate of patients.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R683

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