老年髋部损伤的围手术期风险预测

Risk Analysis of Elder Patients with Hip Injuries within Perioperative Period

目的探讨老年髋部损伤高风险的相关因素,提高对患者手术风险的预测性。方法对172例髋部损伤的患者进行回顾性调查,调查包括:一般情况、病史、受伤情况、临床检验、手术情况以及手术后并发症的发生情况等。对调查结果进行多元回归分析、比较分析,进行统计检验。对目前2种评分方法进行验证。结果发生并发症的患者中,伤前活动差、血红蛋白含量及总蛋白含量较低(有显著差异)。结论老年髋部损伤的治疗选择中,年龄不是手术的禁忌证,血红蛋白、总蛋白的检验结果在一定程度上反映了老年患者的机体状况,在手术风险的预测中有重要意义。

Objective To explore the correlative factors contributing to the preoperative risks of elder patients with hip injuries, in order to improve the risk prediction for surgery. Methods One hundred and seventy - two elder patients with hip injuries hospitalized between 1992 and 1999 were retrospectively investigated and analyzed. The investigation items included general status, history, injury status, clinic test, surgical operation, postoperative complications, etc. The results were analyzed with multiple regression and t - test. The integrative risk index and Karl Miller＇ s risk score were calculated. Results For the most of the patients with postoperative complications, their activity capacity were obviously poor and the contents of haemoglobin and total serum proteins were significantly lower than those of the others, but there was no apparent correlation between the risk and the age. Conclusion The results suggest that the age is not an absolute contraindication for surgical operation as to the elder patients with hip injuries. The contents of hemoglobin and total serum proteins can reflect the physical status of elder patients to a certain extent, and will be useful parameters for the risk prediction.