CAJ | 학술논문

背景：目前对于老年骨折治疗后肺部感染的研究少有报道，对于老年特殊部位，如髋部骨折后围术期肺部感染的并发症也无少见相关报道。目的：探讨老年髋部患者骨折患者围术期合并肺部感染的危险因素。方法：回顾性分析46例老年髋部骨折围术期合并肺部感染的病例资料，并随机选择同时期同一区域住院的未合并肺部感染的老年髋部骨折患者46例作为对照，比较两组患者围术期各临床指标的差异性，合并肺部感染的危险因素行Logistic回归多因素分析。结果与结论：单因素相关分析筛选出14个可能的围术期合并肺部感染相关因素，包括：慢性阻塞性肺病、吸烟、糖尿病、心脏疾病、机械通气、术中出血量、输注红细胞、手术时间、术前低体质量指数(体质量指数<18.5 kg/m2)、血清白蛋白<35 g/L、电解质紊乱、入住ICU及住院时间；Logistic多因素回归分析显示：慢性阻塞性肺病(OR=23.317；95%CI：2.702-60.312；P=0.000)、入住 ICU(OR=7.890；95%CI：2.624-76.012；P=0.008)、机械通气(OR=35.210；95%CI：8.464-131.203；P=0.017)、手术时间(OR=12.122；95%CI：5.154-99.098；P=0.012)为老年髋部骨折患者围术期肺部感染的独立危险因素。说明老年髋部骨折患者存在慢性阻塞性肺病、入住ICU及机械通气等因素时应警惕发生肺部感染的可能。
배경：목전대우노년골절치료후폐부감염적연구소유보도，대우노년특수부위，여관부골절후위술기폐부감염적병발증야무소견상관보도。목적：탐토노년관부환자골절환자위술기합병폐부감염적위험인소。방법：회고성분석46례노년관부골절위술기합병폐부감염적병례자료，병수궤선택동시기동일구역주원적미합병폐부감염적노년관부골절환자46례작위대조，비교량조환자위술기각림상지표적차이성，합병폐부감염적위험인소행Logistic회귀다인소분석。결과여결론：단인소상관분석사선출14개가능적위술기합병폐부감염상관인소，포괄：만성조새성폐병、흡연、당뇨병、심장질병、궤계통기、술중출혈량、수주홍세포、수술시간、술전저체질량지수(체질량지수<18.5 kg/m2)、혈청백단백<35 g/L、전해질문란、입주ICU급주원시간；Logistic다인소회귀분석현시：만성조새성폐병(OR=23.317；95%CI：2.702-60.312；P=0.000)、입주 ICU(OR=7.890；95%CI：2.624-76.012；P=0.008)、궤계통기(OR=35.210；95%CI：8.464-131.203；P=0.017)、수술시간(OR=12.122；95%CI：5.154-99.098；P=0.012)위노년관부골절환자위술기폐부감염적독립위험인소。설명노년관부골절환자존재만성조새성폐병、입주ICU급궤계통기등인소시응경척발생폐부감염적가능。
BACKGROUND:At present, few studies concerned pulmonary infection after treatment of senile fracture. For special parts of senile patients, there are no studies on complications of pulmonary infection in perioperative period after hip fracture. OBJECTIVE:To study risk factors for pulmonary infection in patients with senile hip fractures in perioperative period. METHODS:The data of 46 senile hip fracture patients with perioperative pulmonary infection were retrospectively analyzed. A matched case-control study was conducted in 46 senile hip fracture patients without pulmonary infection in the same hospital and the same period. The difference in perioperative various clinical indexes was compared between the two groups. Risk factors of pulmonary infection received Logistic regression analysis. RESULTS AND CONCLUSION:Multivariate analysis screened out 14 possible perioperative pulmonary infection factors:chronic obstructive pulmonary disease, smoking, diabetes mel itus, heart disease, mechanical ventilation, intraoperative bleeding amount, erythrocyte infusion, operation time, preoperative low body mass index (body mass index<18.5 kg/m2 ), serum albumin<35 g/L, electrolyte disturbance, time of entering intensive care unit and length of stay. Logistic regression analysis displayed that chronic obstructive pulmonary disease (OR=23.317;95%CI:2.702-60.312;P=0.000), entering intensive care unit (OR=7.890;95%CI:2.624-76.012;P=0.008), mechanical ventilation (OR=35.210;95%CI:8.464-131.203;P=0.017) and operation time (OR=12.122;95%CI:5.154-99.098;P=0.012) were independent risk factors for perioperative pulmonary infection in patients with senile hip fracture. These data indicated that one should be alert to the possible occurrence of pulmonary infection in senile hip fracture patients with the presence of chronic obstructive pulmonary disease, entering intensive care unit and mechanical ventilation.