摘要
[目的]探讨80岁以上高龄患者初次行髋关节置换术后1个月内发生并发症的危险因素。[方法]回顾性总结并分析本院2013年9月~2019年4月,初次行人工髋关节置换术的80岁以上高龄患者266例的资料。[结果]患者术后共发生手术相关并发症27例,占10.15%,其中8例术后谵妄,6例急性心肌梗死,4例心力衰竭,3例脑梗,3例术后感染,3例下肢深静脉血栓形成。所有患者均经积极治疗后好转,未出现死亡病例。按是否发生并发症将患者分为两组,有并发症组THA术比率显著高于无并发症组(P<0.05),有并发症组局麻比率显著高于无并发症组(P<0.05),有并发症组术前合并脑部疾病比率显著高于无并发症组(P<0.05),有并发症组输血比率显著高于无并发症组(P<0.05)。多因素逻辑回归分析显示,术前合并脑部疾病(OR=5.466,P<0.05)和输血(OR=4.597,P<0.05)是术后1个月内发生并发症的独立危险因素。[结论]高龄患者行人工髋关节置换术总体安全性较高,但术前合并脑部疾病或输血的患者术后1个月内易发生并发症。
[Objective]To explore the risk factors of complications in a month after primary hip arthroplasty in the elderly.[Methods]A retrospective study was conducted on a total of 266 patients who aged more than 80 years and received unilateral primary hip arthroplasty in our hospital from September 2013 to April 2019.[Results]A total of 27 patients had complications occurred in a month after operation,accounting for 10.15%,including 8 cases of postoperative delirium,6 cases of acute myocardial infarction,4 cases of heart failure,3 cases of cerebral infarction,3 cases of postoperative infection and 3 cases of deep venous thrombosis of lower limbs.All patients got improved after active treatment without death occurred.Based on whether or not complication happened,the 266 patients were divided into two groups.The complication group had significantly higher ratios of total hip arthroplasty,local anesthesia,preoperative comorbidity of cerebropathy and blood transfusion than the non-complication group(P<0.05).Multivariate logistic regression revealed that preoperative comorbidity of cerebropathy(OR=5.466,P<0.05)and blood transfusion(OR=4.597,P<0.05)were independent risk factors for complications within 1 month after operation.[Conclusion]Despite of high overall safety of hip arthroplasty for the elderly,the patients who have preoperative comorbidity of cerebropathy or receive blood transfusion are vulnerable to complications in a month after operation.
作者
王振
胡川
徐熙鹏
郭鹏程
高焕绅
孙一
张海宁
WANG Zhen;HU Chuan;XU Xi-peng;GUO Peng-cheng;GAO Huan-shen;SUN Yi;ZHANG Hai-ming(Department of Orthopedics,Afiliated Haspital,Qingdoo Uninersity,Qingdao 266000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第12期1077-1080,共4页
Orthopedic Journal of China
关键词
老年人
髋关节置换
术后并发症
危险因素
elderly
hip arthroplasty
postoperative complication
risk factors
