443例初次单侧人工髋关节置换患者术前并存疾病的临床分析

Analysis of comorbidities in primary unilateral hip arthroplasty patients:a report of 443 cases

目的探讨初次单侧人工髋关节置换术前并存疾病的发生情况与年龄及住院时间的关系。方法对本组进行的443例初次单侧人工髋关节置换术患者进行回顾,分析患者术前并存疾病发生情况,术前并存疾病数目与年龄及住院时间的关系。结果 443例患者平均年龄64.57岁,平均住院时间21.07d,无术前并存疾病186例,有术前并存疾病257例,术前并存疾病最多有11种。术前并存疾病较常见的有原发性高血压病(116例,26.2%),2型糖尿病(43例,9.7%),冠心病(27例,6.1%),脑中风后遗症(20例,4.5%),心律不齐(19例,4.3%),其他术前并存疾病(32例7.2%)。无术前并存疾病186例(42.0%),平均年龄61.47岁,平均住院时间18.50d;有一种术前并存疾病110例(24.8%),平均年龄62.64岁,平均住院时间20.92天;有两种术前并存疾病76例(17.2%),平均年龄69.25岁,平均住院时间23.76d;有两种以上术前并存疾病71例(16.0%),平均年龄70.66岁,平均住院时间25.15d。无术前并存疾病、有一种术前并存疾病、有两种术前并存疾病患者年龄依次增加,住院时间依次延长,差异有统计学意义(P<0.05);有两种以上术前并存疾病与无术前并存疾病、有一种术前并存疾病患者比较年龄增加,住院时间延长,差异有统计学意义(P<0.05);有两种以上术前并存疾病与有两种术前并存疾病患者比较年龄和住院时间无统计学差异(P>0.05)。结论初次单侧人工髋关节置换术前常合并原发性高血压病、2型糖尿病、冠心病、脑中风后遗症、心律不齐等疾病。随患者年龄增加,术前并存疾病数目增多,住院时间延长,高龄患者容易出现两种及两种以上术前并存疾病,住院时间显著延长。

[ Abstract] Objective To analysis the comorbidities in primary unilateral hip arthroplasty patients, and to explore the correlation between comorbidity and age as well as the length of stay. Methods 443 patients undergoing primary unilateral hip arthroplasty form January, 2005 to December, 2009 were investigated. The comorbidities of such patients were analized. The correlation of comorbidity and age as well as length of stay was explored. Results The average age was 64. 57, and the average length of stay was 21.07 days. 186 cases had eomorbidities, and 257 cases had no eomorbidity. There were maximum ll comorbidities in one single patient. The most prevalent comorbidities were essential hypertension （116 cases, 26. 2% ）, diabetes mellitus （ type 2） （43 cases, 9. 7% ）, coronary heart disease （27 cases,6. 1% ）, sequela of apoplexy （20 cases, 4. 5% ）, arrhythmia （ 19 cases, 4. 3% ）, and other comorbidities （32 cases, 7. 2% ）. The average age and LOS were 61.47 years and 18.5 days in 186 cases （42. 0% ） without comorbidity, 62.64 years and 20. 92 days in 110 cases （24. 8% ） with one comorbidity, 69. 254 years and 23.76 days in 76 cases （ 17.2% ） with two comorbidities and 70. 66 years and 25. 15 days in 71 cases （16. 0% ） with more than two comorbidities respectively. The increase of age and LOS were correlated to the number of comorbidity which the patient had （P 〈 0. 05 ）. Patients with two comorbidities and with more than two comorbidities had no significant difference in age and LOS （P 〉 0. 05 ）. Conclusions The most prevalent comorbidities in primary unilateral hip arthroplasty patients were essential hypertension, diabetes mellitus, coronary heart disease, sequela of apoplexy, and arrhythmia. As the age increasing, the number of comorbidity and the length of stay also increase.