【作者】 马韧石；

【导师】 谷贵山；

【作者基本信息】 吉林大学 ， 临床医学， 2009， 硕士

【摘要】 本文以探索老年髋部骨折患者接受手术治疗的时机与术后并发症是否存在关联为目的,同时确定与术后并发症存在关联的其他因素。我们选择2006年1月-2008年10月在吉林大学第一医院骨科行髋部骨折手术治疗的老年患者62名。准确记录其手术时机,骨折类型,手术方式,术前内科合并症,ASA评分及术中输血量。通过电话随访记录患者术后并发症。根据临床特点对上述记录结果进行分组,运用SAS软件对数据进行比较和统计分析。通过1年的临床研究,我们得到最终得到结论,认为手术时机、性别、年龄、骨折类型、手术方式及ASA评分的各组内术后并发症发生率无显著性差异。术中输血量、术前内科合并症组内的术后并发症率存在显著性差异。手术时机、性别、年龄、骨折类型、手术方式、ASA评分及术中输血量与术后并发症的发生率无因果关联。术前内科合并症与术后并发症的发生率存在因果关联。在髋部骨折手术治疗术后1年的老年患者中,手术时机与术后并发症的发生无因果关联。性别、年龄、骨折类型、手术方式、ASA评分及术中输血量与术后并发症的发生无关联性。术前内科合并症是影响术后并发症发生率的独立因素,与其存在因果联系。与术前无内科合并症的患者相比,术前存在内科合并症患者的术后并发症发生率是其1.651倍。建议老年髋部骨折患者应尽早行手术治疗,以避免因长期卧床使内科合并症加重。本文为老年髋部骨折的临床治疗提供了一定的理论依据。更多还原

【Abstract】 Objective: To discuss the relationship between the timing of the surgery after hip fracture and postoperative complications in senile patients, and find out other factors which are related with these complications. Materials and methods: Sixty-two patients, including 28 males aged from 65 to 72 year-old with mean age of 76.3 year-old and 34 females aged from 65 to 95 year-old with mean age of 78.1 year-old, undergone orthopedics surgery were studied in the retrospective cohort study. Timing of the surgery, the type of fracture, kind of surgery, preoperative comorbidities, ASA score and volume of blood transfusion were extracted from these patients who are followed up by telephone calls for the postoperative complications. The data were divided into subgroups according to the clinical characteristics. All data have been analysed by SAS software. Results: There is not significant difference in the mortality of the postoperative complication in the subgroups of timing of surgery, gender, age, kind of surgery and ASA score. There is significant difference in the mortality of the postoperative complication in the subgroups of preoperative comorbidities and the volume of blood transfusion. There is a significant causality between preoperative comorbidities and postoperative complications. Conclusion: There is no relationship between the timing of surgery and postoperative complications within one year in senile patients who had surgery for hip fracture. No correlations were found between the postoperative complications and gender, age, type of fracture, kind of surgery, ASA sore and the volume of blood volume. Preoperative comorbidities is an independent predictor of the postoperative complications. The mortality of the postoperative complications is 1.651 times higer in patients who have preoperative complications than those without preoperative complications. The operations for the treatment of fractures of the hip in senile patients should be performed as soon as possible to avoid the deterioration of the preoperative comorbidities caused by long-term bed.更多还原