CAJ | 학술논문

背景:髋部骨折是老年人常见的骨折类型,多数有条件的患者均采用手术治疗.但仍有相当部分的病例因各种原因采取非手术治疗.目的:分析影响非手术治疗老年人髋部骨折预后的相关因素.方法:回顾性分析2001年1月至2007年12月收治的61例60岁以上选择非手术治疗的髋部骨折病例的临床资料.采用 SPSS13.0统计软件对临床数据进行单因素及多因素生存分析,以期发现影响非手术治疗老年髋部骨折患者生存的因素.结果与结论:随访至2008年7月,19例患者存活,Harris 评分平均为43.58分.其中<70岁11例, Harris 评分(55.81±29.59)分;>70岁8例,Harris 评分(26.75±23.58)分,两者间比较差异有显著性意义(P <0.05).生存分析显示1,2,5年总存活率分别为0.803±0.051,0.607±0.063,0.301±0.072.单因素分析显示年龄、治疗期间能否早期摆脱卧位状态以及血清白蛋白水平对预后的影响差异具有显著性意义(P <0.05).COX 多因素回归模型分析提示年龄、治疗期间能否早期摆脱卧位状态具有独立预后意义(P <0.05).可见对于非手术方法治疗的70岁以上高龄髋部骨折患者,年龄、治疗期间能否早期摆脱卧位状态是影响生存率的主要因素.
배경:관부골절시노년인상견적골절류형,다수유조건적환자균채용수술치료.단잉유상당부분적병례인각충원인채취비수술치료.목적:분석영향비수술치료노년인관부골절예후적상관인소.방법:회고성분석2001년1월지2007년12월수치적61례60세이상선택비수술치료적관부골절병례적림상자료.채용 SPSS13.0통계연건대림상수거진행단인소급다인소생존분석,이기발현영향비수술치료노년관부골절환자생존적인소.결과여결론:수방지2008년7월,19례환자존활,Harris 평분평균위43.58분.기중<70세11례, Harris 평분(55.81±29.59)분;>70세8례,Harris 평분(26.75±23.58)분,량자간비교차이유현저성의의(P <0.05).생존분석현시1,2,5년총존활솔분별위0.803±0.051,0.607±0.063,0.301±0.072.단인소분석현시년령、치료기간능부조기파탈와위상태이급혈청백단백수평대예후적영향차이구유현저성의의(P <0.05).COX 다인소회귀모형분석제시년령、치료기간능부조기파탈와위상태구유독립예후의의(P <0.05).가견대우비수술방법치료적70세이상고령관부골절환자,년령、치료기간능부조기파탈와위상태시영향생존솔적주요인소.
@@@@BACKGROUND: Hip fracture is common fracture type in the elderly patients, and most of the patients were treated with operation. But there are stil a lot of patients treated with non-operation therapy for a variety of reasons. OBJECTIVE: To explore the factors that influence the prognosis of elderly patients with hip fracture treated non-surgical y. METHODS: Sixty-one elderly patients aged more than 60 years with hip fracture were col ected from January 2001 to December 2007 and treated non-surgical y, and the clinical data of the patients were retrospectively analyzed. Data of comorbidities, Harris hip score and other important data were col ected. The SPSS 13.0 software was used to analyze the prognostic factors through univariate and multivariate method in order to find the factors that could affect the survival of the elderly patients with hip fracture treated non-surgical y. RESULTS AND CONCLUSION: After fol owed-up to July 2008, 19 patients survived. The result of Harris hip score in 19 survival case was 43.58 in average. Among the 19 survival cases, 11 patients < 70 years old and the Harris hip score was (55.81±29.59); 8 patients > 70 years old and the Harris hip score was (26.75±23.58). There was a significant difference of Harris hip score between them (P < 0.05). The 1, 2 and 5 years survival rates of the 61 cases were 0.803±0.051, 0.607±0.063 and 0.301±0.072, respectively. Based on univariate log-rank analysis, age, posture (bedridden or non-bedridden) and the serum albumin concentration had great significance on the prognosis (P < 0.05). COX multivariate regression analysis showed that age and posture (bedridden or non-bedridden) had independent prognostic significance (P < 0.05). It showed that for the elderly patients over 70 years old with hip fracture treated non-surgical y, age and posture (bedridden or non-bedridden) were the main factors to affect the survival rate.