重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2014年
8期
909-912
,共4页
股骨颈骨折%股骨头坏死%危险因素%回归分析
股骨頸骨摺%股骨頭壞死%危險因素%迴歸分析
고골경골절%고골두배사%위험인소%회귀분석
femoral neck fractures%femoral head necrosis%risk factors%regression analysis
目的：探讨股骨头骨折患者内固定术后股骨头坏死（ONFH）的相关危险因素。方法选择该科2010～2012年符合研究要求的股骨颈骨折患者126例，分为ONFH组和对照组，比较两组患者的一般情况、骨折发生情况、骨折治疗情况等方面的差异。结果空心钉锁定板治疗股骨颈骨折患者126例，发生ONFH者17例，患病率为13．49％（17／126）。单因素分析显示，年龄、骨折移位程度分型、受伤至手术间隔时间、复位质量、内固定螺钉位置、是否取出内固定是ONFH的影响因素，差异有统计学意义（P＜0．05）；广义线性模型分析显示，年龄与内固定是否取出、性别与受伤至手术间隔存在交互作用（F＝5．768，P＝0．018；F＝5．542，P＝0．020）；多因素Logistic回归分析显示，年龄、复位质量、受伤至手术间隔时间、性别与受伤至手术间隔是ONFH的危险因素，OR值分别为0．215、0．293、3．162、3．054。结论年龄较大的股骨颈骨折患者，早期实施空心钉锁定板手术，解剖复位好，ONFH发生的可能性小。
目的：探討股骨頭骨摺患者內固定術後股骨頭壞死（ONFH）的相關危險因素。方法選擇該科2010～2012年符閤研究要求的股骨頸骨摺患者126例，分為ONFH組和對照組，比較兩組患者的一般情況、骨摺髮生情況、骨摺治療情況等方麵的差異。結果空心釘鎖定闆治療股骨頸骨摺患者126例，髮生ONFH者17例，患病率為13．49％（17／126）。單因素分析顯示，年齡、骨摺移位程度分型、受傷至手術間隔時間、複位質量、內固定螺釘位置、是否取齣內固定是ONFH的影響因素，差異有統計學意義（P＜0．05）；廣義線性模型分析顯示，年齡與內固定是否取齣、性彆與受傷至手術間隔存在交互作用（F＝5．768，P＝0．018；F＝5．542，P＝0．020）；多因素Logistic迴歸分析顯示，年齡、複位質量、受傷至手術間隔時間、性彆與受傷至手術間隔是ONFH的危險因素，OR值分彆為0．215、0．293、3．162、3．054。結論年齡較大的股骨頸骨摺患者，早期實施空心釘鎖定闆手術，解剖複位好，ONFH髮生的可能性小。
목적：탐토고골두골절환자내고정술후고골두배사（ONFH）적상관위험인소。방법선택해과2010～2012년부합연구요구적고골경골절환자126례，분위ONFH조화대조조，비교량조환자적일반정황、골절발생정황、골절치료정황등방면적차이。결과공심정쇄정판치료고골경골절환자126례，발생ONFH자17례，환병솔위13．49％（17／126）。단인소분석현시，년령、골절이위정도분형、수상지수술간격시간、복위질량、내고정라정위치、시부취출내고정시ONFH적영향인소，차이유통계학의의（P＜0．05）；엄의선성모형분석현시，년령여내고정시부취출、성별여수상지수술간격존재교호작용（F＝5．768，P＝0．018；F＝5．542，P＝0．020）；다인소Logistic회귀분석현시，년령、복위질량、수상지수술간격시간、성별여수상지수술간격시ONFH적위험인소，OR치분별위0．215、0．293、3．162、3．054。결론년령교대적고골경골절환자，조기실시공심정쇄정판수술，해부복위호，ONFH발생적가능성소。
Objective To investigate the risk factors of influencing femoral head necrosis (ONFH) after treatment with internal fixation of femoral head fracture .Methods 126 patients with femoral neck fracture admitted from 2010 to 2012 in the hospital ,and treated by locking plate and cannulated screw ,were divided into the ONFH group and the control group .Patient condition ,fracture situation ,fracture treatment .etc were compared between the two groups .Results Among 126 patients with femoral neck fracture treated by locking plate and cannulated screw ,17 cases in the ONFH group were founded ,the prevalence rate of ONFH was 13 .49% (17/126) .Univariate analysis showed that ,age ,garden type ,quality of reduction ,injury-to-surgery interval ,screw place-ment ,whether to remove the internal fixation were influencing factors ,the difference was statistically significant (P<0 .05) .Gener-alized linear model analysis showed that there was interaction between age and internal fixation ,gender and injury-to-surgery (F=5 .768 ,P=0 .018 ;F=5 .542 ,P=0 .020) .Multiple Logistic regression analysis showed that ,age ,quality of reduction ,injury-to-sur-gery interval ,gender and injury-to-surgery were risk factors of ONFH ,OR were 0 .215 ,0 .293 ,3 .162 ,3 .054 ,respectively .Conclu-sion The elderly patient with femoral neck fracture treated by locking plate and cannulated screw early with excellent anatomic re-duction ,has less incidence of ONFH .
