老年髋部骨折患者术后生存分析  

The postoperative survival rate analysis of elderly patients with hip fracture

作　　者：张树良[1] 郑隆宝[1] 侯振海[1] 倪志明[1] 顾江军[1] 叶虹[1] 

机构地区：[1]中国人民解放军第117医院创伤骨科,杭州310004

出　　处：《中华老年医学杂志》2015年第7期778-781,共4页Chinese Journal of Geriatrics

基　　金：南京军区医药卫生科研基金（12z42）

摘　　要：目的研究老年髋部骨折患者术后不同时间的生存率及其相关影响因素。方法对2008年6月至2011年6月间本院收治的获得完整随访的255例老年髋部骨折手术病例进行随访研究，对术后6个月、1年、2年和3年的生存率及其相关影响因素进行研究。结果255例老年髋部骨折术后6个月时生存率为96．5％，术后1年时生存率为89．8％，术后2年时生存率为78．0％，术后3年时生存率为69．4％。生存分析显示术前合并疾病种类多、低白蛋白血症、高龄和重度贫血是生存的危险因素，受伤前日常生活能力好是生存的保护因素。性别、骨折类型、美国麻醉医师协会分级、手术距受伤时间、麻醉方式、手术方式、手术时间、术中出血量及住院时间对术后生存无影响。结论老年髋部骨折患者术后生存率受到多种因素影响，为提高生存率应积极治疗术前内科合并疾病，纠正贫血和低白蛋白血症。应采取有针对性的治疗、康复方法以提高老年髋部骨折患者术后的生活自理能力，提高术后生存率。Objective To study the postoperative survival rate of elderly patients with hip fracture at different time and its related factors. Methods We conducted the follow-up studies of 255 elderly hip fracture patients from June 2008 to June 2011 in our hospital. The survival rates of patients at 6 months, 1, 2 and 3 years after operation and their related factors were studied. Results The survival rate was 96.5%, 89.8%, 78.0% and 69.4% at 6 months, 1, 2 and 3 years after operation respectively in 255 elderly hip fracture patients. Survival analysis showed that many kinds of preoperative comorbidities, low albumin level, old age and severe anemia were the risk factors for survival. Good activity of daily living before injury was a protective factor for survival. Gender, fracture type, the American Society of Anesthesiologists （ASA） classification, time from injury to surgery, anesthesia type, surgical approach, operative time, blood loss and hospital stay periods had no effect on survival after operation. Conclusions The survival rate in elderly patients with hip fracture after surgery is affected by many factors. Preoperative coraorbidities, anemia and hypoaibuminemia should be actively treated, the activity of daily living should be improved by the directed therapy and rehabilitation, in order to improve the survival rate in elderly patients with hip fracture.

关 键 词：髋骨折 存活率分析 危险因素 

分 类 号：R687.3[医药卫生—骨科学]