本文關(guān)鍵詞： 股骨粗隆間骨折 老年人 危險因素 死亡率　出處：《廣州中醫(yī)藥大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的： 探討影響老年股骨粗隆間骨折患者生存的因素,為提高老年股骨粗隆間骨折患者生存率及生存質(zhì)量提供臨床依據(jù)。 方法： 回顧性分析2012年3月至2013年3月于我院住院治療的174例老年股骨粗隆間骨折患者,其中152例獲得隨訪并納入研究。對患者年齡、性別、生理學指標、骨折類型、傷前合并癥數(shù)量及類型、ASA評級、POSSUM生理學評分、Hb、ALB、手術(shù)時機、手術(shù)方式、手術(shù)時間、麻醉方式、圍手術(shù)期輸血情況、傷后并發(fā)癥、抗骨質(zhì)疏松治療等因素先進行單因素分析,對有統(tǒng)計學意義的變量再進行多因素Logistic回歸分析,判斷該因素是否為影響老年股骨粗隆間骨折患者死亡的獨立危險因素。 結(jié)果： 對于老年股骨粗隆間骨折患者,年齡、性別、血清白蛋白、血紅蛋白、ASA評級、POSSUM生理學評分、傷前合并癥的數(shù)量、傷前合并心臟疾病、合并呼吸系統(tǒng)疾病、治療方式、呼吸系統(tǒng)并發(fā)癥、消化系統(tǒng)并發(fā)癥及心血管系統(tǒng)并發(fā)癥是其1年死亡的影響因素。通過多元回歸分析后得出,心血管系統(tǒng)并發(fā)癥及呼吸系統(tǒng)并發(fā)癥,是老年股骨粗隆間骨折患者1年死亡的獨立危險因素。 對于老年股骨粗隆間骨折手術(shù)患者,年齡、血清白蛋白、ASA評級、POSSUM生理學評分、傷前合并癥的數(shù)量、傷前合并心臟疾病、合并呼吸系統(tǒng)疾病、術(shù)后發(fā)生呼吸系統(tǒng)并發(fā)癥及心血管系統(tǒng)并發(fā)癥是術(shù)后1年死亡的影響因素。通過多元回歸分析后得出,術(shù)后呼吸系統(tǒng)并發(fā)癥及心血管系統(tǒng)并發(fā)癥,是老年股骨粗隆間骨折患者1年內(nèi)死亡的獨立危險因素。 結(jié)論： 呼吸系統(tǒng)并發(fā)癥及心血管系統(tǒng)并發(fā)癥是老年股骨粗隆間骨折患者及手術(shù)患者1年死亡的獨立危險因素。白蛋白、血紅蛋白、ASA評級、POSSUM生理學評分、治療方式、傷前合并病數(shù)量、心臟疾病或呼吸系統(tǒng)合并癥對患者死亡率有影響。 因此,加強對老年股骨粗隆間骨折患者內(nèi)科情況的了解,對患者全身狀況作充分評估,改善患者營養(yǎng)情況及內(nèi)科病情況,預防心血管系統(tǒng)、呼吸系統(tǒng)并發(fā)癥發(fā)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.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R683

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