合并心脏瓣膜病对老年髋部骨折患者围术期并发症的影响

Effect of heart valve disease on perioperative complications in elderly patients with hip fracture

目的探讨合并心脏瓣膜病对老年髋部骨折患者围术期并发症的影响。方法回顾性分析2017年5月至2020年12月北京积水潭医院收治的3838例老年髋部骨折患者的临床资料,根据患者是否合并心脏瓣膜病分为观察组(合并心脏瓣膜病,55例)和对照组(不合并心脏瓣膜病,3783例)。比较分析两组患者的临床资料,围术期并发症发生情况以及心功能不全发病率。结果两组患者的年龄、性别、骨折类型和基础疾病等一般资料比较差异均无显著性(P>0.05)。两组患者的下肢深静脉血栓、泌尿系感染、压疮发生情况比较差异均无显著性(P>0.05);观察组患者的呼吸道感染发生率和心功能不全发病率均显著高于对照组(P<0.05)。结论合并心脏瓣膜病可增加老年髋部骨折患者围术期呼吸道感染风险,其机制可能与心脏瓣膜病易导致老年患者心功能不全相关。

Objective To investigate the effect of heart valve disease on perioperative complications in elderly patients with hip fracture.Method The clinical data of 3838 elderly patients with hip fracture admitted to Beijing Jishuitan Hospital from May 2017 to December 2020 were retrospectively analyzed.They were divided into observation group(with heart valve disease,55 cases)and control group(without heart valve disease,3783 cases)according to whether combined with heart valve disease.The clinical data,perioperative complications and cardiac insufficiency were compared and analyzed between the two groups.Result There were no significant differences in age,gender,classification of fracture and basic diseases between two groups(P>0.05).There were no significant differences in the occurrence of lower extremity deep vein thrombosis,urinary tract infection and pressure ulcers between two groups(P>0.05).The incidences of respiratory tract infection and cardiac insufficiency in observation group were significantly higher than those in control group(P<0.05).Conclusion Heart valve disease increases the risk of perioperative respiratory tract infection in elderly patients with hip fracture,and the mechanism is related to the fact that heart valve disease easily leads to cardiac insufficiency in elderly patients.