摘要
目的 探讨降低髋部周围骨折住院患者死亡率的对策. 方法 对1999年1月至2013年1月北京大学人民医院创伤骨科髋部周围骨折住院死亡患者的资料进行回顾性分析,总结创伤骨科髋部周围骨折住院死亡患者的临床特点,分析其死亡原因及预防对策. 结果 髋部周围骨折住院患者死亡率为1.12％ （21/1 881）.21例死亡患者中,男1 1例,女10例;平均年龄为（79.8±6.7）岁（62 ～ 93岁）.致伤原因：摔伤19例,交通伤l例,坠落伤1例.骨折部位：髋臼骨折1例,股骨颈骨折7例,股骨转子间骨折11例,股骨转子下骨折2例.21例死亡患者术前血红蛋白含量平均为（114.5±18.6） g/L,总蛋白含量平均为（58.6±10.9） g/L,白蛋白含量平均为（33.2±8.5） g/L.7例死亡患者采用手术治疗.主要合并内科疾病：呼吸系统疾病14例（66.67％）,心血管系统疾病16例（76.19％）,脑血管疾病5例（23.81％）,泌尿系统疾病l例（4.76％）.死亡原因：呼吸衰竭11例（52.38％）,肺栓塞4例（19.05％）,多器官功能障碍3例（14.29％）,急性心肌梗死、急性大面积脑梗死及脑出血各1例（4.76％）. 结论 本组髋部周围骨折住院死亡患者均为老年人,常合并多种内科疾病,以呼吸系统疾病和心血管系统疾病常见.肺部感染所致呼吸衰竭是导致髋部周围骨折住院患者死亡的主要原因,应加以预防,以降低死亡率.
Objective To analyze the inpatient deaths from orthopaedic and traumatic hip fractures and to provide countermeasures to reduce such deaths.Methods A retrospective study was performed to analyze the inpatient deaths from hip fractures in our department from January 1999 to January 2013.Their clinical features,causes of death,major complications,and risk factors leading to death were analyzed to find out preventative measures.Results The hospital mortality of hip fracture inpatients was 1.12% （21/1,881）.Of the 21 deaths,11 were male and 10 female.Their ages averaged 79.8 ± 6.7 years （from 62 to 93 years）.They were hospitalized for trauma,caused by falling in 19 cases,traffic accident in one,and falling from a height in one.There were one acetabular fracture,7 femoral neck fractures,11 intertrochanteric fractures and 2 subtrochanteric fractures.Of the 21 deaths,the average hemoglobin level was 114.5 ± 18.6 g/L,the average total protein level 58.6 ± 10.9 g/L,and the average albumin level 33.2 ±8.5 g/L before operation.They all received surgery.Their major complications were respiratory disease in 14 cases （66.67%）,cardiovascular disease in 16 cases （76.19%）,cerebrovascular disease in 5 cases （23.81%）,and urinary system disease in one （4.76%）.The causes of death were respiratory failure in 11 cases （52.38%）,pulmonary embolism in 4 cases （19.05%）,multiple organ dysfunction syndrome in 3 cases （14.29%）,acute myocardial infarction in one （4.76%）,cerebral hemorrhage in one（4.76%） and cerebral infarction in one （4.76%）.Conclusions The inpatient deaths from hip fractures may occur in the elderly who are complicated with several internal disorders,especially respiratory and cardiovascular diseases.Since respiratory failure caused by pulmonary infection is the chief cause for deaths in the old inpatients with hip fracture,it should be regarded with great caution in order to reduce the post-traumatic mortality.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2014年第8期679-683,共5页
Chinese Journal of Orthopaedic Trauma
基金
卫生部公益性行业科研专项（201002014）
“985”经费-教育部长江学者和创新团队发展计划项目（IRT1201）.
关键词
髋臼
骨折
髋骨折
死亡率
Acetabulum
Fractures, bone
Hip fractures
Mortality
