基于日常生活活动能力评估量表判断老年髋部骨折患者术后生存率的临床研究  

Clinical study on judging the survival rate of elderly patients with hip fracture based on the activity of daily living ability assessment scale

作　　者：夏怀华[1] 吕香梅 姜红燕[1] Xia Huaihua;Lyu Xiangmei;Jiang Hongyan(The Shanghai Fifth People's Hospital of Shanghai , Fudan University , Shanghai 200240)

机构地区：[1]复旦大学附属上海市第五人民医院

出　　处：《护士进修杂志》2019年第17期1555-1558,共4页Journal of Nurses Training

摘　　要：目的探讨日常生活活动能力(Activities of daily living,ADL)评分在评估老年髋部骨折患者术后1年生存率的作用,为今后的护理策略提供依据。方法选取2015年7月-2017年5月入住我院骨科病房的60岁以上老年髋部骨折患者132例,术前进行ADL评分,进行为期1年的随访研究,并采用生存分析模型对患者术后1年的生存率进行相关性分析。结果术后1年总生存率为90.1%;ADL良好是生存的独立保护因素,对生存影响的优势比为0.252[95%CI(0.388-0.992),P=0.041],ADL评分>60分的患者术后生存率提高;而高龄是患者术后生存的独立高风险因素,对生存影响的风险比为4.482[95%CI(1.016-1.500),P=0.044],年龄高于75岁以上生存率降低。而且在本研究中,性别、骨折类型、手术方式、麻醉方式、手术时间、术中出血量、合并疾病种类以及术前血红蛋白含量对患者术后1年生存率无影响。结论术前年龄高于75岁、ADL评分低于60分的老年髋部骨折患者,应该采取有针对性的治疗、康复方法提高患者的ADL,以提高患者术后生存率。Objective To analyze the role of the activity of daily living(ADL) score in evaluating the survival rate of elder patients with hip fracture in order to provide a basis for future nursing strategies.Methods A total of 132 patients with hip fractures over 60 years old who were admitted to the orthopaedic ward of the Fifth people's hospital of Shanghai from July 2015 to May 2017 were enrolled. The ADL score was performed before surgery for a one-year follow-up study. The survival analysis model was used to analyze the correlation of the 1-year survival rate after fracture. Results The 1-year overall survival rate was 90.1%. Good daily living activities are protective factors for survival, and the odds ratio for survival is 0.252 [95% CI(0.388-0.992), P=0.041]. Elder was a high risk factor for postoperative survival. The OR=4.482 [95% CI(1.016-1.500), P=0.044]. The survival rate was reduced over the age of 75. Survival rates decreased when the ADL score below 60. Gender, fracture pattern, surgical procedure, anesthesia, surgical procedure, intra-operative blood loss, length of hospital stay, and preoperative combined disease had no effect on postoperative survival.Conclusion Elder patients with hip fracture who are older than 75 years old and have an ADL score of less than 60 points should take targeted treatment and rehabilitation methods to improve their daily living activities and improve their postoperative survival rate.

关 键 词：老年 髋部骨折 日常生活活动能力 护理对策 

分 类 号：R473.6[医药卫生—护理学]