合并慢性阻塞性肺疾病对老年髋部骨折患者术后病死率及功能恢复的影响  

Influence of Combination of Chronic Obstructive Pulmonary Disease on Postoperative Mortality and Functional Rehabilitation of Elderly Patients with Hip Fracture

作　　者：李绍光[1] 王晓伟[1] 刘智[1] 任继鑫[1] 孙天胜[1] 

机构地区：[1]北京军区总医院全军创伤骨科研究所,北京100700

出　　处：《解放军医药杂志》2013年第5期37-40,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：军队临床高新技术重大项目(2010gxjs007);国际科技合作计划(2010DFA31250)

摘　　要：目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)对老年髋部骨折患者术后病死率及功能恢复的影响。方法 2008年10月—2010月9月,前瞻性收集连续住院的老年髋部骨折病例,记录患者一般特征、合并慢性疾病、骨折及手术类型、住院时间等资料,根据呼吸功能检查分为合并COPD组及未合并COPD组,在伤后30 d、6个月、1年分别随访记录并比较分析两组存活及功能恢复情况。结果共入选老年髋部骨折345例,其中73例合并COPD(合并COPD组),272例未合并COPD(未合并COPD组)。COPD组与未合并COPD组术后30 d、6个月、1年的病死率分别为26.0%、41.1%、64.4%和2.2%、11.0%、16.9%,差异有统计学意义(P<0.01)。两组骨折前活动能力比较差异无统计学意义(P>0.05),术后1年随访合并COPD组存活者功能恢复率低于未合并COPD组(P<0.05)。结论合并COPD的老年髋部骨折患者术后病死率显著升高,功能恢复更差。Objective To explore the influence of chronic obstructive pulmonary disease （COPD） on postoper- ative mortality and functional rehabilitation of elderly patients with hip fracture. Methods Clinical histories of consecu- tively hospitalized elderly patients with hip fracture during October 2008 and September 2010 in our hospital were collect- ed. Epidemiological characteristics, combination of chronic illness, type of fractures and operations, and lengths of stay were recorded. The patients were divided into combination of COPD （group A） and no combination of COPD （group B） according to respiratory function examinations, and survival rates and functional recovery degrees of the two groups were recorded and compared with follow-up at 30 days, 6 months and 1 year after injuries. Results A total of 345 patients were involved in the study, among them 73 patients were diagnosed as having COPD （group A） ,and 272 patients without COPD （ group B）. The mortalities at 30 days, 6 months and 1 year after operation in group A and group B were 26.0% , 41.1% and 64.4% , and 2.2% , 11. 0% and 16. 9% respectively. There were significant differences between two groups （ P 〈 0.01 ）. Before injury there was no significant difference of locomotor activity in two groups （ P 〉 0.05 ）. Sur- vivors functional recovery rate in group A was significantly worse than that in group B after one year follow-up （P 〈 0. 05）. Conclusion Elderly patients with hip fracture and combination of COPD have much higher risk of death, and have worse functional recovery.

关 键 词：髋骨折 肺疾病 慢性阻塞性 病死率 功能恢复 

分 类 号：R683.3[医药卫生—骨科学] R563.9[医药卫生—外科学]