摘要
目的 :使用回归分析的方法进行老年股骨干骨折围手术期发生心衰的研究,寻找其相关危险因素,从而对其围手术心衰提出相应的临床建议。方法:对2012年7月至2017年4月期间行手术治疗的143例老年股骨干骨折患者进行回顾性分析,围手术期发生心衰组25例,男10例,女15例,年龄(77.2±12.5)岁;未发生心衰组118例,男54例,女64例,年龄(71.1±10.6)岁。调阅病例资料记录收集其受伤至手术时间、高血压病史、心脏病病史、意识障碍、术前肾功能、手术方式、手术时间、麻醉方式、围手术期液体出入量差值、围手术期疼痛评分、术后血红蛋白等资料。比较两组患者的各个因素,对结果有意义的因素再行多因素Logistic回归分析,以明确独立的危险因素。结果:单因素分析显示两组在年龄、心脏病病史、术前肾功能、围手术期液体出入量差值均有统计学意义(P<0.05),多因素Logistic回归分析显示患者围手术期发生心衰的危险因素分别是为年龄[P=0.016,OR=2.789(1.208,6.439)],心脏病病史[P=0.011,OR=2.878(1.269,6.527)],术前肾功能[P=0.043,OR=2.410(1.027,5.654)],围手术期液体出入量差值[P=0.022,OR=4.215(1.230,14.439)]。结论 :年龄、心脏病病史、术前肾功能、围手术期液体出入量差值为老年股骨干骨折患者发生围手术期心衰的危险因素,围手术期应充分重视及评估这些危险因素的危害,并采用积极有效的预防和治疗措施。
Objective：To study the risk factors of perioperative heart failure in the elderly patients with femoral shaft fracture by the regression analysis,so as to provide relevant clinical reference. Methods：From July 2012 to April 2017,143 elderly patients with femoral shaft fracture who underwent surgical treatment in our hospital were retrospectively studied.Among them,25 patients with perioperative heart failure included 10 males and 15 females with a mean age of（77.2±12.5）years old; 118 patients without heart failure included 54 males and 64 females with a mean age of（71.1±10.6） years old. The data of the time from injury to operation,hypertension history,heart disease history,disturbance of consciousness,preoperative renal function,operation method,operation time,anesthesia mode,perioperative fluid volume difference,perioperative pain score,postoperative hemoglobin were collected and recorded. The various factors of the two groups were compared,and a multiple factor Logistic regression analysis was performed on the meaningful results in order to identify the independent risk factors. Results：Univariate analysis showed that age,heart disease history,preoperative renal function and perioperative fluid volume had statistical difference between the two groups（P 0.05）. Multivariate analysis showed that the independent risk factors of perioperative heart failure were age [P=0.016,OR=2.789（1.208,6.439）],heart disease history [P=0.011,OR=2.878（1.269,6.527）],preoperative renal function [P =0.043,OR =2.410（1.027,5.654）],the perioperative fluid volume difference[P =0.022,OR =4.215（1.230,14.439）]. Conclusion：The age,heart disease history,preoperative renal function and perioperative fluid balance are the risk factors of perioperative heart failure in elderly patients with femoral fracture. During the perioperative period,we should pay full attention to and evaluate the hazards of these risk factors and adopt effective and effective prevention and treatment measures.
出处
《中国骨伤》
CAS
2018年第2期150-154,共5页
China Journal of Orthopaedics and Traumatology
关键词
股骨骨折
围手术期
心力衰竭
危险因素
Femoral fractures
Perioperative period
Heart failure
Risk factors
