高龄骨折患者围术期合并医院获得性肺炎相关因素的病例对照研究  

Study on the Postoperative Risk Factors of Hospital-acquired Pneumonia in Patients with Senile Fractures

作　　者：欧阳卫东[1] 陈晓文[1] 胡开来[1] 廖凡琼[1] 张洪钦[1] 

机构地区：[1]中国人民解放军第四二一医院干部病房,广州510318

出　　处：《医学综述》2014年第18期3435-3437,共3页Medical Recapitulate

摘　　要：目的 探讨高龄骨折患者围术期合并医院获得性肺炎（HAP）的危险因素.方法 采用病例对照研究的方法收集2008年10月至2012年10月中国人民解放军第四二一医院收治的老年骨折围术期合并HAP患者39例（HAP组）,并随机选择同期老年骨折患者围术期不合并HAP患者39例（非HAP组）,比较两组患者围术期各项临床指标的差异,行多因素Logistic回归分析.结果 多因素Logistic回归分析结果显示：COPD（OR =23.317;95％ CI：2.702～ 60.312;P =0.000）、入住ICU（OR =14.163;95％ CI：1.624～112.012;P=0.005）、机械通气（OR =30.210;95％ CI：8.164～ 134.203;P=0.007）、手术时间（OR =9.018;95％ CI：1.074～ 88.119;P =0.022）为高龄骨折患者围术期合并HAP的独立危险因素.结论 高龄骨折患者存在COPD、入住ICU、机械通气及手术时间长等因素时应警惕术后发生HAP的可能性.Objective To study the postoperative risk Factms of hospital-acquired pneumonia（HAP） in patients with senile fractures.Methods A total of 39 cases of senile fracture patients with hospital-acquired pneumonia admitted in No.421 H ospital of PLA from Oct.2008 to Oct.2012 were selected as H AP group,and another 39 cases of senile fracture patients with no HAP during the same period were selected as non-HAP group.The clinical indexes of the two groups during perioperative period were analyzed by muhivariate Logistic regression analysis.Results Results of muhivariate Logistic regression analysis showed：COPD（OR =23.317 ; 95 % CI：2.702-60.312 ; P =0.000）,ICU（OR =14.163 ; 95% CI：1.624-112.012 ; P =0.005）,mechanical ventilation（OR =30.210 ; 95% CI：8.164-134.203 ;P =0.007）,duration of operation （OR =9.018 ; 95 % CI：1.074-88.119 ; P =0.022）.Conclusion COPD,IC U,mechanical ventilation,duration of operation are the postoperative risk factors of hospital-acquired pneumonia in patients with senile fractures.

关 键 词：高龄骨折 医院获得性肺炎 相关因素 

分 类 号：R619.3[医药卫生—外科学]