影响髋臼骨折手术疗效的相关因素分析

Logistic Analysis of the Influencing Factors of Operative Effect in Acetabular Fracture

目的探讨影响髋臼骨折手术疗效的相关因素。方法收集2004年1月至2008年6月手术治疗的髋臼骨折患者148例,手术疗效按改良Merled’Aubign-éPostel髋臼骨折功能评级进行评分,根据可能影响手术疗效的若干因素,如年龄、性别、手术时机、手术入路、骨折类型、骨折复位质量及异位骨化等10个指标对手术疗效进行单因素分析,对有意义的指标采用Logistic多因素回归分析。结果135例获得随访,平均随访28.5个月（6~60个月）。单因素分析显示骨折类型、手术时机、骨折复位质量、是否有股骨头软骨面损伤、关节腔内是否有碎骨块和异位骨化与髋臼骨折手术疗效优良率有关（P〈0.05）。Logistic多因素回归分析显示手术时机和骨折复位质量是影响髋臼骨折术后功能结果的独立危险因素。结论手术时机和骨折复位质量可能是影响髋臼骨折术后功能结果的独立危险因素。骨折复位质量是其中最重要的可控性因素。

Objective To investigate the influencing factors of operative effect in acetabular fracture.Methods A retrospective analysis was made on 148 patients with acetabular fracture who underwent operation from January 2004 to June 2008.The operative effect was assessed according to modified Merled＇ Aubigné-Postel score.Firstly,single factor analysis was used in 10 clinical variables,including age,gender,operative timing,operative approach,classification of fracture,diaplastic quality of fracture and heterotopic ossification.Then,multivariate logistic regression analysis was used in the selected variables.Results 135 patients were followed up for average 28.5 months（6 to 60 months）.Single factor analysis showed that classification of fracture,operative timing,diaplastic quality of fracture,femoral head cartilage injury or not,intra-articular bone block or not and heterotopic ossification were significantly correlated with operative effect（P0.05）.Multivariate logistic regression analysis showed that operative timing and diaplastic quality of fracture were two independent risk factors for operative effect.Conclusion Operative timing and diaplastic quality of fracture are two independent risk factors for operative effect in acetabular fracture.The diaplastic quality of fracture is the most important controllable factor.