老年髋部骨折患者术后吸入性肺炎危险因素及短期预后的分析  

Retrospective analysis of risk factors and prognosis of postoperative aspiration pneumonia in elderly patients with hip fracture

作　　者：姜骆永 黄晓阳[1] 谢伟[1] 岑景文[1] 李瑛[2] 王满宜 孙炜[1] JIANG Luoyong;HUANG Xiaoyang;XIE Wei;CEN Jingwen;LI Ying;WANG Manyi;SUN Wei(Department of Orthopedics,the First Affiliated Hospital of Shenzhen University/Shenzhen Second People′s Hospital,Shenzhen 518000,China;不详)

机构地区：[1]深圳大学第一附属医院/深圳市第二人民医院骨科,广东深圳518000 [2]深圳大学第一附属医院/深圳市第二人民医院老年医学科,广东深圳518000

出　　处：《实用医学杂志》2020年第16期2264-2268,共5页The Journal of Practical Medicine

基　　金：北京市医院管理局重点医学专业发展计划建设项目—杨帆计划(编号:ZYLX201506);2020年广东省高水平临床重点专科资助项目(编号:SZGSP007-20203357018,SZGSP007-2020335022);深圳市卫生计生系统重点学科建设能力提升项目(编号:201506029)。

摘　　要：目的本研究旨在探讨老年髋部骨折术后患者吸入性肺炎的危险因素,以及对短期预后的影响。方法回顾性分析2016年1月至2019年12月深圳市第二人民医院行手术治疗的545例年龄>65岁的髋部骨折患者,分为吸入性肺炎组和无吸入性肺炎组(对照组)。收集临床资料,包括人口统计学资料、ASA分类、既往病史、实验室检查结果、手术相关因素在吸入性肺炎组和对照组之间进行比较。应用单因素Logistic回归分析筛选出术后吸入性肺炎可能的危险因素,再纳入多因素logistic回归分析。为了评估吸入性肺炎的短期预后,还将住院时间、重症监护病房的住院频率和院内病死率在两组间进行了比较。结果28例(5.1%)老年髋部骨折术后患者确诊为吸入性肺炎。年龄增加、体质指数低、营养不良、脑卒中、手术时间长和手术延迟为吸入性肺炎的危险因素。在预后方面,吸入性肺炎组的住院时间、入住重症监护病房病例和院内病死率显著升高。结论吸入性肺炎组患者术后与对照组患者相比,预后较差。较长的术前等待时间和手术时间被确定为吸入性肺炎的危险因素。因此,治疗髋部骨折时,应设法缩短术前等待时间和手术时间。Objective The purpose of this study was to investigate the risk factors of aspiration pneumonia in elderly patients with hip fractures and its impact on short-term prognosis.Methods A retrospective analysis of 545 hip fracture patients older than 65 years old who underwent surgical treatment in Shenzhen Second People’s Hospital from January 2016 to December 2019 was divided into aspiration pneumonia group and non-aspiration pneumonia group(Control group).Clinical data were collected,including demographic factors,ASA classification,previous medical history,laboratory test results,and surgery-related factors between the aspiration pneumonia group and the control group.Single-factor logistic regression analysis was used to screen out the possible risk factors for postoperative aspiration pneumonia,and then included in multi-factor logistic regression analysis.In order to assess the short-term prognosis of aspiration pneumonia,the length of hospitalization,the frequency of hospitalization in the intensive care unit and the hospital mortality rate were compared between the two groups.Results 28(5.1%)elderly patients with hip fractures were diagnosed with aspiration pneumonia.Increasing age,low body mass index,malnutrition,stroke,long operation time and delayed operation were identified as risk factors for aspiration pneumonia.In terms of prognosis,the length of hospitalization,cases admitted to the intensive care unit,and in-hospital mortality in the aspiration pneumonia group increased significantly.Conclusion Patients in the aspiration pneumonia group have a poorer prognosis than those in the control group.Longer operation time and waiting time before surgery were identified as risk factors for aspiration pneumonia.Therefore,when treating hip fractures,try to shorten the waiting time and operation time before surgery.

关 键 词：老年 髋部骨折 吸入性肺炎 危险因素 预后 

分 类 号：R683.42[医药卫生—骨科学]