本文選題：病案首頁 + 股骨近端骨折　； 參考：《中國中醫(yī)科學院》2017年碩士論文

【摘要】：研究目的通過對2003年至2016年真實世界中,望京醫(yī)院股骨近端骨折住院患者病案首頁的研究,收集整理出患者的一般信息、治療信息、合并癥信息、并發(fā)癥信息,并找出各個信息之間的聯(lián)系,從而探討股骨近端骨折住院患者并發(fā)癥的風險因素。研究方法從中國中醫(yī)科學院望京醫(yī)院病案信息系統(tǒng)數(shù)據(jù)庫中,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頁信息,將對信息進行核查、清洗,通過復(fù)雜網(wǎng)絡(luò)的方式進行數(shù)據(jù)挖掘,將可利用的信息建立Exce1數(shù)據(jù)庫。進行一般統(tǒng)計描述,針對有統(tǒng)計學意義的信息進行Logistic單因素二元回顧驗證,最后做Logistic多因素二元回顧分析,找出常見并發(fā)癥:貧血、低蛋白血癥、肺部感染的相關(guān)風險因素。統(tǒng)計結(jié)果本次研究納入望京醫(yī)院2003年-2016年全部股骨近端骨折病例數(shù)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齡71.27歲,發(fā)生股骨近端骨折最多的是75-79歲年齡段共368例,占比18.61%;患者的平均住院天數(shù)為26.21天,其中住院20-24天的患者最多,占比19.98%;經(jīng)過整理后發(fā)現(xiàn)出現(xiàn)最多的合并癥依次為高血壓病、冠狀動脈粥樣硬化性心臟病、陳舊性腦血管病、糖尿病、心律失常、慢性呼吸系統(tǒng)疾病、骨質(zhì)疏松,其他合并癥由于發(fā)生頻次少,未納入合并癥列表;出現(xiàn)最多的前六位并發(fā)癥依次為貧血、低蛋白血癥、肺部感染、下肢靜脈血栓、電解質(zhì)紊亂、泌尿系感染,最終選取發(fā)病頻次前三位為本次研究的因變量。Logistic多因素二元回顧顯示,股骨近端骨折治療過程中貧血的相關(guān)影響因素為女性、年齡、高血壓病、手術(shù)、使用中草藥;低蛋白血癥的相關(guān)影響因素為年齡、住院天數(shù)、陳舊性腦血管病、手術(shù)、使用中草藥;肺部感染的相關(guān)影響因素為年齡、住院天數(shù)、慢性呼吸系統(tǒng)疾病、使用中草藥。結(jié)論1股骨近端骨折患病人群主要為高齡患者,女性多于男性,伴隨最多的合并癥依次為:高血壓病、冠狀動脈粥樣硬化性心臟病、陳舊性腦血管病、糖尿病、心律失常、慢性呼吸系統(tǒng)疾病、骨質(zhì)疏松,并發(fā)癥發(fā)生率最高的疾病依次為:貧血、低蛋白血癥、肺部感染、下肢靜脈血栓、電解質(zhì)紊亂、泌尿系感染。2女性、高齡、高血壓、手術(shù)與并發(fā)貧血存在明顯關(guān)聯(lián);高齡、住院天數(shù)、陳舊性腦血管疾病、手術(shù)與并發(fā)低蛋白血癥存在明顯關(guān)聯(lián);高齡、住院天數(shù)、合并慢性呼吸系統(tǒng)疾病與并發(fā)肺部感染存在明顯關(guān)聯(lián)。3中醫(yī)藥可能在股骨近端骨折治療中發(fā)揮了積極作用。
[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.
【學位授予單位】：中國中醫(yī)科學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R683

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