老年多发肋骨骨折患者肺部并发症的危险因素

Risk Factors for Pulmonary Complications in Older Patients with Multiple Rib Fractures

目的探究老年多发肋骨骨折患者肺部并发症的影响因素。方法选取新疆医科大学第二附属医院2017年1月~2020年12月收治的92例老年多发肋骨骨折患者进行回顾性分析,根据是否发生肺部并发症分为病例组(46例)与对照组(46例),收集两组年龄、处理时间、肺部基础疾病、吸烟史、糖尿病史、其他部位骨折、肋骨骨折根数、镇痛药物治疗等指标,进行统计学分析,将单因素分析结果中P<0.05的因素作为自变量,是否发生肺部并发症作为因变量进行多因素logistic回归分析。结果单因素分析结果显示:肺部并发症与处理时间、年龄、肺部基础疾病、糖尿病史、吸烟史、肋骨骨折数量等因素有关(P<0.05)。多因素logistic回归分析显示:年龄、有肺部基础疾病、有糖尿病史、有吸烟史、肋骨骨折数量7~12根是肺部并发症发生的独立危险因素(P<0.05)。结论对于有糖尿病史、肺部基础疾病、吸烟史,肋骨骨折数≥7根的老年多发肋骨骨折患者,应给予早期的预防性干预。

Objective To investigate the factors influencing pulmonary complications in older patients with multiple rib fractures.Methods A total of 92 older patients with multiple rib fractures admitted to the Second Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2020 were selected for retrospective analysis.The patients were divided into the case group(46 cases) and the control group(46 cases) according to the occurrence of pulmonary complications.The information including the age, time of treatment, underlying pulmonary disease, history of smoking, history of diabetes, fractures at other sites, number of rib fractures, use of analgesia was collected and analyzed.The factors with P<0.05 in the results of univariate analysis were used as independent variables, and the occurrence of pulmonary complications was used as a dependent variable for multivariate logistic regression analysis.Results Univariate analysis showed that the pulmonary complications were associated with time of treatment, age, underlying lung disease, history of diabetes, history of smoking, and number of rib fractures(P<0.05).Multivariate logistic regression analysis showed that the age, presence of underlying lung disease, history of diabetes, history of smoking, and number of rib fractures(7 to 12) were independent risk factors for the development of pulmonary complications(P<0.05).Conclusion Early prophylactic intervention should be given to older patients with multiple rib fractures who have a history of diabetes, underlying pulmonary disease, a history of smoking, and a number of rib fractures≥7.