高龄骨科手术患者术后并发症发生的影响因素分析  

Analysis of risk factors affecting postoperative complications in elderly patients undergoing orthopedic surgery

作　　者：孟莉[1] 廖涛[1] 梁佳佳[1] MENG Li;LIAO Tao;UANG Jia-jia(Sichuan Orthopaedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《实用医院临床杂志》2019年第3期50-52,共3页Practical Journal of Clinical Medicine

基　　金：四川省卫生厅科研基金资助项目(编号:120158)

摘　　要：目的分析影响高龄骨科手术患者术后并发症发生的危险因素。方法我院296例高龄骨科手术患者,根据术后是否发生并发症,分为并发症组(n=59)和无并发症组(n=237),比较两组临床资料差异,分析影响高龄骨科手术患者术后并发症发生的危险因素。结果并发症组年龄≥85岁,合并高血压、冠心病、脑血管疾病、呼吸系统疾病,NYHA分级Ⅲ～Ⅳ级,白蛋白<35 g/L,血红蛋白<110 g/L,ASA分级≥Ⅲ级,手术时间≥2 h,输血患者比例均高于无并发症组(P <0. 05)。Logistic回归分析显示:合并呼吸系统疾病、NYHA分级Ⅲ～Ⅳ级、白蛋白<35 g/L、ASA分级≥Ⅲ级、输血是影响影响高龄骨科手术患者术后并发症发生的独立危险因素(P <0. 05)。结论高龄骨科手术患者术后并发症发生率较高,合并呼吸系统疾病、NYHA分级Ⅲ～Ⅳ级、白蛋白<35 g/L、ASA分级≥Ⅲ级、输血将增加高龄骨科手术患者并发症发生风险。Objective To analyze the risk factors affecting postoperative complications in elderly patients with orthopedic surgery.Methods The clinical data of 296 elderly patients undergoing orthopedic surgery in our hospital were retrospectively analyzed.According to the presence or absence of postoperative complications,the patients were divided into complication group(n=59)and noncomplication group(n=237).The differences in clinical data were compared between the two groups.Risk factors for occurrence of postoperative complications in the patients were analyzed.Results The proportions of patients with age≥85 years old,combined hyperten-sion,coronary heart disease,cerebrovascular disease and respiratory disease,NYHA gradeⅢ~Ⅳ,albumin<35 g/L,hemoglobin<110 g/L,ASA grade≥grade III,operative time≥2 h and blood transfusion in the complication group were significantly higher than those in the non-complication group(P<0.05).The logistic regression analysis showed that combined respiratory disease,NYHA gradeⅢ~Ⅳ,albumin<35 g/L,ASA grade≥Ⅲand blood transfusion were independent risk factors affecting postoperative complications in these patients(P<0.05).Conclusion The incidence rate of postoperative complications is high in elderly patients with orthopedic surgery.Combined respiratory disease,NYHA gradeⅢ~Ⅳ,albumin<35 g/L,ASA grade≥Ⅲand blood transfusion may increase the risk of complications in these patients.

关 键 词：高龄 骨科手术 并发症 危险因素 

分 类 号：R68[医药卫生—骨科学]