基于logitics回归模型分析影响骨盆骨折患者髂腹股沟入路术疗效的原因及对策

Analysis based on logistics regression model on reasons and countermeasures that affect efficacy of iliac-groin approach for patients with pelvic fracture

目的探讨影响骨盆骨折患者髂腹股沟入路术疗效的原因及对策。方法选取2010年1月至2019年12月茂名市电白区人民医院骨科收治的62例骨盆骨折患者作为研究对象,根据术后疗效为有效组和无效组。比较两组患者的一般资料,采用单因素和多因素分析影响骨盆骨折患者术后疗效的影响因素。结果62例患者中,优31例(50.00%),良9例(14.52%),可10例(16.13%),差12例(19.35%)。有效组50例,男性22例,女性28例,年龄(52.43±6.61)岁;无效组12例,男性5例,女性7例,年龄(52.56±6.64)岁。单因素分析显示,有效组的手术时机、复位质量、合并伤、术后并发症与无效组比较,差异均有统计学意义(χ^(2)=9.460,P=0.002;χ^(2)=27.050,P<0.001;χ^(2)=6.400,P=0.011;χ^(2)=16.800,P<0.001)。多因素logistics回归分析显示,影响术后疗效的危险因素主要为手术时机、复位质量、合并伤、术后并发症,差异均有统计学意义(P<0.001,OR=2.748;P<0.001,OR=3.216;P<0.001,OR=2.846;P<0.001,OR=3.770)。结论手术时机、复位质量、合并伤、术后并发症是影响骨盆骨折患者髂腹股沟入路术疗效的独立保护因素,针对疗效的影响因素,通过选择合适的手术时机、提高复位质量、减少术后并发症等措施,提高骨盆骨折患者术后疗效。

Objective To explore the reasons affecting the curative effect of iliac-groin approach for patients with pelvic fracture and the countermeasures.Methods Sixty-two patients with pelvic fracture admitted to Department of Orthopedics,People's Hospital of Dianbai District,Maoming from January 2010 to December 2019 were collected as the research objects,and were divided into an effective group(50 cases)and an ineffective group(12 cases)according to the postoperative efficacy.The general data of the two groups were compared.Univariate analysis and multivariate analysis were used to analyze the factors influencing the postoperative efficacy.Results Among the 62 patients,31(50.00%)had excellent effect,9(14.52%)good,10(16.13%)not bad,and 12(19.35%)poor.The effective group had 50 cases,including 22 males and 28 females,and they were(52.43±6.61)years old.The ineffective group had 12 cases,including 5 males and 12 females,and they were(52.56±6.64)years old.Univariate analysis showed that the operation timing,reduction quality,complicated injury,and postoperative complications of the effective group were statistically different from those of the ineffective group(χ^(2)=9.460,P=0.002;χ^(2)=27.050,P<0.001;χ^(2)=6.400,P=0.011;andχ^(2)=16.800,P<0.001).Multivariate logistics regression analysis showed that the main risk factors affecting the postoperative efficacy were operation timing,reduction quality,complicated injury,and postoperative complications(P<0.001,OR=2.748;P<0.001,OR=3.216;P<0.001,OR=2.846;P<0.001,OR=3.770).Conclusions Operation timing,reduction quality,complicated injury,and postoperative complications are independent protective factors that affect the efficacy of iliac-groin approach for patients with pelvic fractures.Aiming at the factors affecting the efficacy,by choosing the appropriate operation timing,increasing the quality of reduction,and reducing postoperative complications,the curative effect of patients with pelvic fractures is improved.