基于病案首页对股骨近端骨折预后影响因素的回顾性研究

发布时间：2018-06-06 08:20

本文选题：病案首页 + 股骨近端骨折　；参考：《中国中医科学院》2017年硕士论文

【摘要】：研究目的通过对2003年至2016年真实世界中,望京医院股骨近端骨折住院患者病案首页的研究,收集整理出患者的一般信息、治疗信息、合并症信息、并发症信息,并找出各个信息之间的联系,从而探讨股骨近端骨折住院患者并发症的风险因素。研究方法从中国中医科学院望京医院病案信息系统数据库中,提取2003年1月1日至2016年12月31日的所有股骨近端骨折患者首页信息,将对信息进行核查、清洗,通过复杂网络的方式进行数据挖掘,将可利用的信息建立Exce1数据库。进行一般统计描述,针对有统计学意义的信息进行Logistic单因素二元回顾验证,最后做Logistic多因素二元回顾分析,找出常见并发症:贫血、低蛋白血症、肺部感染的相关风险因素。统计结果本次研究纳入望京医院2003年-2016年全部股骨近端骨折病例数1977例,其中男性798例占40.36%,女性1179例占59.64%;股骨近端骨折患者平均年龄71.27岁,发生股骨近端骨折最多的是75-79岁年龄段共368例,占比18.61%;患者的平均住院天数为26.21天,其中住院20-24天的患者最多,占比19.98%;经过整理后发现出现最多的合并症依次为高血压病、冠状动脉粥样硬化性心脏病、陈旧性脑血管病、糖尿病、心律失常、慢性呼吸系统疾病、骨质疏松,其他合并症由于发生频次少,未纳入合并症列表;出现最多的前六位并发症依次为贫血、低蛋白血症、肺部感染、下肢静脉血栓、电解质紊乱、泌尿系感染,最终选取发病频次前三位为本次研究的因变量。Logistic多因素二元回顾显示,股骨近端骨折治疗过程中贫血的相关影响因素为女性、年龄、高血压病、手术、使用中草药;低蛋白血症的相关影响因素为年龄、住院天数、陈旧性脑血管病、手术、使用中草药;肺部感染的相关影响因素为年龄、住院天数、慢性呼吸系统疾病、使用中草药。结论1股骨近端骨折患病人群主要为高龄患者,女性多于男性,伴随最多的合并症依次为:高血压病、冠状动脉粥样硬化性心脏病、陈旧性脑血管病、糖尿病、心律失常、慢性呼吸系统疾病、骨质疏松,并发症发生率最高的疾病依次为:贫血、低蛋白血症、肺部感染、下肢静脉血栓、电解质紊乱、泌尿系感染。2女性、高龄、高血压、手术与并发贫血存在明显关联;高龄、住院天数、陈旧性脑血管疾病、手术与并发低蛋白血症存在明显关联;高龄、住院天数、合并慢性呼吸系统疾病与并发肺部感染存在明显关联。3中医药可能在股骨近端骨折治疗中发挥了积极作用。
[Abstract]:Objective to collect the general information, treatment information, complication information of patients with proximal femoral fracture in Wangjing Hospital from 2003 to 2016 in the real world. To explore the risk factors of complications in patients with proximal femur fracture. Methods from the database of medical record information system of Wangjing Hospital, Chinese Academy of traditional Chinese Medicine, the first page information of all patients with proximal femoral fracture from January 1, 2003 to December 31, 2016 was extracted, and the information was checked and cleaned. The Exce1 database is established by using the data mining method of complex network. General statistical description, Logistic univariate binary review of statistical information, and Logistic multivariate retrospective analysis were done to find out the common complications: anemia, hypoproteinemia, pulmonary infection related risk factors. Results the study included 1977 cases of proximal femur fracture in Wangjing Hospital from 2003 to 2016, of which 798 cases were male and 1179 cases were female. The average age of the patients with proximal femoral fracture was 71.27 years old. The most common cases of proximal femoral fractures were 368 cases between 75 and 79 years old, accounting for 18.61.The average hospitalization days of the patients were 26.21 days, of which 20-24 days of hospitalization were the most, accounting for 19.98%. After finishing, it was found that the most common complications were hypertension. Coronary atherosclerotic heart disease, old cerebrovascular disease, diabetes, arrhythmia, chronic respiratory diseases, osteoporosis, other complications due to less frequency, not included in the list of complications; The first six most common complications were anemia, hypoproteinemia, pulmonary infection, venous thrombosis of lower extremity, electrolyte disturbance, urinary tract infection, Finally, the first three factors were selected as the dependent variable. Logistic multivariate review showed that the related factors of anemia in the treatment of proximal femoral fracture were female, age, hypertension, surgery, and the use of Chinese herbal medicine. The related factors of hypoproteinemia were age, length of stay in hospital, old cerebrovascular disease, operation, use of Chinese herbal medicine, and the related factors of pulmonary infection were age, length of stay in hospital, chronic respiratory system disease, use of Chinese herbal medicine. Conclusion (1) the patients with proximal femur fracture are mainly elderly patients, female is more than male, and the most associated complications are hypertension, coronary atherosclerotic heart disease, old cerebrovascular disease, diabetes mellitus, arrhythmia. The diseases with the highest incidence of chronic respiratory diseases, osteoporosis and complications were anemia, hypoproteinemia, pulmonary infection, venous thrombosis of the lower extremities, electrolyte disturbance, urinary tract infection of .2 women, old age, high blood pressure. There was a significant correlation between operation and anemia, old age, hospital stay, old cerebrovascular disease, surgery and hypoproteinemia. There is a significant correlation between chronic respiratory diseases and pulmonary infection. 3 Chinese medicine may play an active role in the treatment of proximal femoral fractures.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R683

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