CAJ | 학술논문

目的：研究骨科高龄髋部手术患者临床分析及E-PASS评分系统在风险评估中的应用。方法：选择2012年1月～2014年6月高龄髋部骨折患者188例作为研究对象。分析患者麻醉及手术情况，术后并发症情况，评估E-PASS评分系统对患者死亡率的手术风险，对比E-PASS评分系统评估并发症、死亡情况与实际情况的差异。结果：手术类型为单侧全髋置换术的比例最高，为42.02%，其次为单侧半髋置换术25.53%及骨折内固定术20.21%。麻醉类型以全身麻醉为主，占比70.74%。术后并发症主要以呼吸系统类疾病为主，占并发症比例为25.88%，占总病例比例为11.70%。其次为心血管疾病和泌尿系统类疾病。E-PASS评分系统显示，有并发症组患者经手术风险评估的死亡率显著高于无并发症组，差异有统计学意义。经E-PASS评分系统评估的并发症发生例数为91例，实际发生85例，实际值/预测值为0.93；评估死亡例数为6例，实际死亡2例，实际值/预测值为0.33，差异均无统计学意义。结论：对接受髋部手术的骨科高龄患者进行E-PASS评估，预测其并发症情况及死亡风险，具有较大的应用价值。
목적：연구골과고령관부수술환자림상분석급E-PASS평분계통재풍험평고중적응용。방법：선택2012년1월～2014년6월고령관부골절환자188례작위연구대상。분석환자마취급수술정황，술후병발증정황，평고E-PASS평분계통대환자사망솔적수술풍험，대비E-PASS평분계통평고병발증、사망정황여실제정황적차이。결과：수술류형위단측전관치환술적비례최고，위42.02%，기차위단측반관치환술25.53%급골절내고정술20.21%。마취류형이전신마취위주，점비70.74%。술후병발증주요이호흡계통류질병위주，점병발증비례위25.88%，점총병례비례위11.70%。기차위심혈관질병화비뇨계통류질병。E-PASS평분계통현시，유병발증조환자경수술풍험평고적사망솔현저고우무병발증조，차이유통계학의의。경E-PASS평분계통평고적병발증발생례수위91례，실제발생85례，실제치/예측치위0.93；평고사망례수위6례，실제사망2례，실제치/예측치위0.33，차이균무통계학의의。결론：대접수관부수술적골과고령환자진행E-PASS평고，예측기병발증정황급사망풍험，구유교대적응용개치。
ObjectiveTo study E - PASS scoring system for orthopaedic senile hip surgery risk assessment.Methods From January 2012 to June 2014 188 cases of elderly hip fracture patients as the research object. Anesthesia and surgery, post-operative complications, evaluation of E - PASS scoring system for patients with the mortality of operation risk, compared to E - PASS scoring system to assess complications.Results The operation type for the highest percentage of unilateral total hip replacement was 42.02%, followed by one and a half total hip arthroplasty 25.53% and fracture fixation 20.21%. Anesthesia type was given priority to with general anesthesia, accounted for 70.74%. Postoperative complications mainly respiratory system diseases, accounting for complication rate was 25.88%, to 11.70% of total cases. Secondly for cardiovascular disease (CVD) and urinary system diseases. E - PASS scoring system, according to the mortality of patients with complications after surgery risk assessment group was significantly higher than without complications, the difference was statistically significant. Via E - PASS scoring system to assess complications of cases to 91 cases, the actual 85 cases, the actual value/forecast was 0.93; Assess the death cases, 6 cases, the actual death in 2 cases, the actual value/forecast was 0.33, there were no statistically significant differ-ence (χ2 = 2.104, 1.231,P= 0.056, 0.124).Conclusion In patients with hip surgery orthopaedics - old E - PASS assessment, predict the risk of complications and death, has great application value.