老年多发性肋骨骨折患者术后发生肺部并发症的影响因素分析

Influencing factors of postoperative pulmonary complications in elderly patients with multiple rib fractures Abs

目的 探讨老年多发性肋骨骨折患者术后发生肺部并发症的影响因素,为临床老年多发性肋骨骨折术后并发肺部并发症的预防及治疗提供参考。方法 回顾性分析110例老年多发性肋骨骨折患者的临床资料,术后2个月根据术后是否发生肺部并发症分为有肺部并发症组(32例)和无肺部并发症组(78例)。记录并比较两组患者的性别、年龄、肺部基础疾病、吸烟史、咳痰情况、就诊时间等一般资料,采用Logistic回归模型分析老年多发性肋骨骨折患者术后发生肺部并发症的影响因素。结果 110例老年多发性肋骨骨折术后患者发生肺部并发症32例,发生率为29.09%。其中肺炎12例(10.91%),肺不张8例(7.27%),刺激性咳嗽7例(6.36%),胸腔积液3例(2.73%),咳血2例(1.82%)。有肺部并发症组患者的肺部基础疾病、有吸烟史、咳痰情况差、就诊时间≥24 h的占比分别为56.25%、68.75%、62.50%、31.25%,均高于无肺部并发症组的25.64%、41.03%、32.05%、10.26%,差异具有统计学意义(P<0.05)。采用二分类Logistic回归模型分析2.1中列出的影响老年多发性肋骨骨折患者术后发生肺部并发症相关因素差异变量,研究结果显示,有肺部基础疾病、有吸烟史、咳痰情况差为老年多发性肋骨骨折患者术后发生肺部并发症的独立危险因素(P<0.05)。结论 老年多发性肋骨骨折患者术后发生肺部并发症受多种因素影响,临床医师应重点关注有肺部基础疾病、有吸烟史、咳痰情况差的患者,早期采取有效干预措施,降低术后肺部并发症发生率。

Objective To discuss the influencing factors of postoperative pulmonary complications in elderly patients with multiple rib fractures,so as to provide reference for the prevention and treatment of postoperative pulmonary complications in elderly patients with multiple rib fractures.Methods The clinical data of 110 elderly patients with multiple rib fractures were analyzed retrospectively.2 months after surgery,they were divided into pulmonary complications group(32 cases) and non-pulmonary complications group(78 cases) according to whether pulmonary complications occurred after surgery.The general data,such as gender,age,underlying pulmonary diseases,smoking history,expectoration and treatment time,of the two groups were recorded and compared.The risk factors of postoperative pulmonary complications in elderly patients with multiple rib fractures were analyzed by Logistic regression model.Results Among 110 elderly patients with multiple rib fractures,32 cases had pulmonary complications,with an incidence rate of 29.09%,including12 cases(10.91%) of pneumonia,8 cases(7.27%) of atelectasis,7 cases(6.36%) of irritant cough,3 cases(2.73%)of pleural effusion,and 2 ases (1.82%) of hemoptysis.The proportions of underlying pulmonary diseases,smoking history,poor expectoration,and treatment time≥24 h in pulmonary complications group were 56.25%,68.75%,62.50%,and 31.25%,which were higher than 25.64%,41.03%,32.05%,10.26%in non-pulmonary complication group,and the differences were statistically significant (P<0.05).The dichotomous Logistic regression model was used to analyze the variables listed in 2.1 that affect the factors related to postoperative pulmonary complications in elderly patients with multiple rib fractures.The results of the study showed that underlying pulmonary diseases,smoking history,and poor expectoration were independent risk factors for postoperative pulmonary complications in elderly patients with multiple rib fractures (P<0.05).Conclusion Postoperative pulmonary complications in elderly patients with multiple rib fractures are affected by many factors.Clinicians should focus on patients with underlying pulmonary diseases,smoking history and poor expectoration,and take effective intervention measures early to reduce the rate of postoperative pulmonary complications.