老年髋部骨折患者合并慢性阻塞性肺疾病围手术期的危险因素和防治研究

摘要

Objective: To analyze and investigate the risk factors and prevention for elderly patients with hip fracture accompanied with chronic obstructive pulmonary disease during perioperation, and to provide reference for improving the level of diagnosis and treatment. Methods: A retrospective study was adopted on the data of elderly patients with hip fracture in three hospitals, and the patients accompanied with chronic obstructive pulmonary disease were divided in observation group(100 cases), while patients without that were divided in control group (100 cases). To analyze the clinical characteristics, treatment and prognosis of the two groups, and count the total mortality rates of patients with hip fracture in perioperative period, 3 months post cure and 1 year post cure, respectively. And analyzed the influences of risk factors of hip fracture accompanied with chronic obstructive pulmonary for mortality rate. Results: The average postoperative recovery times of observation group and control group were 25.4 days and 21.3 days, respectively. The mortality rates of perioperative period, 3 months post cure and 1year post cure of the two groups, respectively, were 22%, 38% and 52% in observation group, and were 8%, 15% and 19% in control group. The function recovery time post cure of observation group was significant worse than that of control group (t=11.39, P<0.05). Conclusion: Accompanied with chronic obstructive pulmonary disease is one of independent risk factors for elderly patients with hip fracture in perioperation, and this result has guiding significance in correlation prevention and research. It can provide reference of diagnosis and treatment for clinical research.%目的:分析探讨老年髋部骨折患者合并慢性阻塞性肺疾病围手术期的危险因素,为提高防治水平提供借鉴.方法:对3家医院收治的老年髋部骨折患者病例资料进行回顾性研究,将合并慢性阻塞性肺疾病老年患者分为观察组,无合并慢性阻塞性肺疾病分为对照组,每组100例,分析两组患者的临床特点、治疗和预后情况,统计患者髋部骨折患者围手术期、治疗后3个月、1年的总病死率,分析合并慢性阻塞性肺疾病的危险因素对病死率的影响.结果:观察组和对照组患者平均术后功能恢复时间分别为25.4 d、21.3 d;观察组和对照组患者围手术期、治疗后3个月、1年的病死率分别为22%、38%、52%和8%、15%、19%;观察组在术后功能恢复时间的预后差于对照组,差异有统计学意义(t=11.39,P<0.05).结论:合并慢性阻塞性肺疾病可作为老年髋部骨折患者围手术期的独立危险因素之一,在防治研究中具有指导意义,可为临床研究提供更多的诊治参考.