摘要
[目的]建立骨科手术风险度评分标准,并验证其效能。[方法]对本院2009年3月～2010年8月期间768例骨科手术病人的术前、术中临床资料进行单因素对比分析,筛选引起手术并发症的风险因素,然后对这些风险因素进行Logistic多元回归分析,建立骨科手术风险度评分标准。运用此评分标准对本院2010年9月～2010年11月160例脊柱外科患有脊柱疾患的手术病人进行评估,并验证其效能。[结果]多因素分析显示年龄、术前4周内手术次数、手术级别、术中出血量、胸片异常、心功能、血糖、白蛋白、手术时间、肾功是术后出现并发症的风险因素。依此评分标准评估术后并发症的总体符合率达到80%以上。[结论]在围手术期应用骨科手术风险度评分(ORAOS)能够较准确的预测骨科手术后并发症的发生。严格地选择病人、做好充分的术前准备及正确的围手术期处理是降低并发症的关键。
[ Objective] To establish a scoring standard of operative risk assessment for the orthopaedic surgery（ORAOS） and evaluate the reliability of the system. [ Method ] Anivariable analysis was performed for the preoperative and intraoperative clinical data of the 768 patients undergone orthopaedic surgery in our hospital between March 2009 and August 2010. The risk factors associated with orthopaedic surgery were selected and multivariablely analyzed with logistic regression performed for the selected risk factors. Thus the scoring standard were established according to these data. We evaluated reliability of the standard by assessment of 160 patients in spinal surgery between September 2010 and November 2010 compared with the real situation of each operation. [ ResultJ Anivariable analysis showed factors such as age, number of operative variables within four weeks,mag- nitude, volume of intraoperative blood loss, abnormal sternum, heart function, albumin, blood sugar, timing of operation, renal function were risk factors. We found that 80% of the patients were predicted correctly through this standard. [ Conclusion] The ORAOS may appropriately predict the occurrence of patients＇postoperative complication before operation. Appropriate indication and meticulous perioperative care are paramount to minimize risks.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2012年第18期1647-1652,共6页
Orthopedic Journal of China
关键词
骨科手术风险度评分
术后并发症
危险因素
operative risk assessment for orthopaedic surgery, postoperative complication, risk factors
