摘要
目的探讨老年人在髋部骨折手术后临床预后不良的独立危险因素。方法回顾性分析2009年1月至2016年12月行髋部骨折手术的2 005例患者的临床资料,将术后发生急性脑卒中作为患者出现不良预后的指标,根据术后2周内是否发生急性脑卒中将患者分为卒中组(48例)和正常组(1 957例),比较2组患者各项指标。分析2组患者临床预后情况。采用Logistic回归模型分析老年人髋部骨折术后发生急性脑卒中的危险因素。结果正常组男性患者67.96%,女性患者32.04%;卒中组男性患者41.67%,女性患者58.33%。老年髋部骨折术后女性发生急性脑卒中的比例显著大于男性,差异有统计学意义(P<0.05)。正常组患三种以上内科疾病和发生术中血压异常的比例显著低于卒中组,差异有统计学意义(P<0.05)。有心律失常病史(OR=5.868,P=0.002),脑卒中病史(OR=4.261,P=0,011)和术中血压出现异常(OR=3.468,P=0.019),是老年髋部骨折术后急性脑卒中发生的独立危险因素(P<0.05)。结论老年人髋部骨折术后发生急性脑卒中的独立危险因素是有心律失常病史、脑卒中病史和术中血压出现异常。
Objective To investigate the independent risk factors of poor prognosis in elderly patients with hip fracture after operation.Methods The clinical data about 2005 patients with hip fracture who were admitted and treated by surgery in our hospital from January 2009 to December 2016 were retrospectively analyzed,in which,the acute cerebral stroke after operation was regarded as poor prognosis index.According to whether the patients had acute cerebral stroke on 2 weeks after operation,the patients were divided into two groups:stroke group(n=48)and control group(n=1957).The various relevant indexes were analyzed and compared between two groups,moreover,the independent risk factors influencing the incidence of acute cerebral stroke in elderly patients with hip fracture after operation were analyzed by Logistic regression method.Results The male patients accounted for 67.96%and female patients accounted for 32.04%in control group,however,the male patients accounted for 41.67%and female patients accounted for 58.33%in stroke group.The female patients who had acute cerebral stroke after operation in stroke group were significantly more than those in control group(P<0.05).The patients who had more than 3 kinds of internal diseases and suffered from abnormal blood pressure in stroke group were significantly less than those in control group(P<0.05).Multiple factors analysis showed that the history of cardiac arrhythmias(OR=5.868,P<0.01),the history of cerebral stroke(OR=4.261,P<0.05)and the incidence of intraoperative blood pressure abnormality(OR=3.468,P<0.05)were the independent risk factors influencing the incidence of acute cerebral stroke in elderly patients with hip fracture after operation are history of cardiac arrhythmias,the history of cerebral stroke and incidence of intraoperative blood pressure abnormality.
作者
李文利
杨宝辉
翁张涛
姜亮
LI Wenli;YANG Baohui;WENG Zhangtao(Department of Orthopaedics,The First Hospital of Weinan City,Shaanxi,Weinan 714000,China)
出处
《河北医药》
CAS
2018年第5期655-657,662,共4页
Hebei Medical Journal
关键词
老年人
髋部骨折
脑卒中
急性
the elderly
hip fracture
acute cerebral stroke
