老年髋部骨折术后近期日常生活功能水平及其影响因素研究

Study on the level of daily living function and its influencing factors in elderly patients after hip fracture surgery

目的:分析老年髋部骨折术后近期预后情况,并探讨影响日常生活功能恢复的主要因素。方法:分析2015年11月至2016年11月130例老年髋部骨折手术患者资料,男43例,女87例;年龄60~95(77.54±8.49)岁。记录术后3个月死亡、跌倒、并发症情况,采用日常生活功能恢复量表(function recovery scale,FRS)随访患者术后3个月的日常生活功能。运用t检验、方差分析及单因素线性回归分析对一般临床资料进行分析,将P<0.05的因素采用多因素线性回归方法分析得出术后日常生活功能的影响因素。结果:130例术后3个月死亡7例(5.4%),跌倒4例(3.1%),103例(79.2%)发生术后并发症,123例存活患者FRS评分65.92±22.79。分析发现不同性别、年龄段、骨折部位、骨折前巴塞尔评级、虚弱指数、术后住院天数、术后并发症总数对术后日常生活功能恢复的差异具有统计学意义(P<0.05);多元线性回归分析提示骨折前巴塞尔评级(t=-2.727,P=0.007)、虚弱指数(t=-2.573,P=0.011)、术后住院天数(t=-3.391,P=0.001)、术后并发症总数(t=-3.281,P=0.001)是影响老年髋部骨折患者术后日常生活功能的独立危险因素(R^(2)=0.411)。结论:老年髋部骨折术后近期康复水平欠佳,骨折前巴塞尔评级、虚弱指数、术后住院天数、术后并发症总数可能是影响患者术后日常生活功能恢复的相关危险因素。

Objective:To analyze the short-term prognosis of elderly patients with hip fracture after operation,and to explore the main factors affecting the recovery of daily life function.Methods:From November 2015 to November 2016,130 elderly patients with hip fracture were analyzed,including 43 males and 87 females,aged from 60 to 95(77.54±8.49)years.The death,fall and complications were recorded 3 months after operation.The daily life function of the patients was followed up 3 months after operation with the functional recovery of daily life scale(FRS).T-test,analysis of variance and single factor linear regression analysis were used to analyze the general clinical data.The factors with P<0.05 were analyzed by multi factor linear regression method,and the influencing factors of postoperative ADL were obtained.Results:Among 130 patients,7 died(5.4%),4 fell(3.1%),103(79.2%)had postoperative complications,and the FRS score of 123 patients was 65.92±22.79.The results showed that gender,age,fracture site,pre fracture Basel rating,frailty index,postoperative hospital stay and total number of postoperative complications had significant differences in the recovery of daily life function(P<0.05);multiple linear regression analysis showed that pre fracture Basel rating(t=-2.727,P=0.007),frailty index(t=-2.573,P=0.011)and postoperative hospital stay had significant differences.The days of hospital stay(t=-3.391,P=0.001)and the total number of postoperative complications(t=-3.281,P=0.001)were the independent risk factors for postoperative ADL in elderly patients with hip fracture(R^(2)=0.411).Conclusion:The short-term rehabilitation level of elderly patients with hip fracture after operation is poor.Basel rating before fracture,frailty index,postoperative hospital stay and total number of postoperative complications may be related risk factors affecting the recovery of daily life function of patients after operation.