广西南宁市急性骨筋膜室综合征患者截肢危险因素分析  

Analysis of risk factors of amputation in patients with acute osteofascial compartment syndrome in Nanning,Guangxi

作　　者：李俊锋 黄钊[1] 程洪 冯启明[3] 陈丁泉 覃娴静 郑铁军 凌赫 苏伟[1] 赵劲民[1,2] Li Junfeng;Huang Zhao;Cheng Hong;Feng Qiming;Chen Dingquan;Qin Xianjing;Zheng Tiejun;Ling He;Su Wei;Zhao Jinmin(Orthopaedic Trauma Hand Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Guangxi Biomedical Collaborative Innovation Center,Guangxi Medical University,Nanning 530021,China;Centre for Health and Health Policy Research,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院创伤骨科手外科,南宁530021 [2]广西医科大学广西生物医药协同创新中心 [3]广西医科大学卫生与健康政策研究中心,南宁530021

出　　处：《广西医科大学学报》2022年第3期488-493,共6页Journal of Guangxi Medical University

基　　金：国家自然科学基金面上项目(No.81972120);广西重点研发计划资助项目(No.桂科AB19110017);广西自然科学基金资助项目(No.2019GXNSFAA245065,No.桂科AD20159024)。

摘　　要：目的:分析2010-2019年广西南宁市急性骨筋膜室综合征(ACS)截肢发生率的变化趋势及危险因素,为预防其发生提供参考。方法:收集2010-2019年南宁市6家综合医院诊治的ACS患者的临床资料,采用单因素及多因素Logistic回归分析影响患者发生截肢的危险因素。结果:共收集378例患者,其中截肢64例,总截肢率为16.93%;2010-2019年期间,广西南宁市ACS患者的截肢率呈下降趋势(P_(趋势)<0.05)。多因素Logistic回归分析显示:高能量损伤(OR=2.136,95%CI:1.050~4.343)、合并血管损伤(OR=2.553,95%CI:1.301~5.011)、合并感染(OR=3.120,95%CI:1.539~6.327)、转院治疗(OR=4.164,95%CI:1.853~9.354)以及未切开减压(OR=5.383,95%CI:1.143~25.348)是患者截肢的危险因素。结论:广西南宁市ACS的截肢率呈下降趋势;高能量损伤、合并血管损伤、合并感染、转院治疗以及未切开减压是ACS患者发生截肢的危险因素。Objective:To analyze the changing trend and risk factors of amputation in acute osteofascial compartment syndrome(ACS) in Nanning,Guangxi from 2010 to 2019,in order to provide reference for preventing its occurrence.Methods:The clinical data of ACS patients treated in 6 general hospitals in Nanning from 2010 to2019 were collected,and the risk factors of amputation were analyzed by multivariate Logistic regression.Results:A total of 378 patients were collected,of which 64 were amputated,and the total amputation rate was16.93%.During the period from 2010 to 2019,the amputation rate of ACS patients in Nanning,Guangxi showed a downward trend(Ptrend<0.05).Multivariate Logistic regression analysis showed that high energy injury(OR=2.136,95% CI:1.050-4.343),combined vascular injury(OR=2.553,95% CI:1.301-5.011),combined infection(OR=3.120,95% CI:1.539-6.327),transfer to hospital(OR=4.164,95% CI:1.853-9.354) and unopened decompression(OR=5.383,95% CI:1.143-25.348) were risk factors for amputation.Conclusion:The amputation rate of ACS in Nanning,Guangxi showed a downward trend,and high energy injury,combined vascular injury,combined infection,transfer to hospital and unopened decompression are the risk factors of amputation in patients with ACS.

关 键 词：截肢 危险因素 骨筋膜室综合征 回顾性分析 

分 类 号：R686.3[医药卫生—骨科学]