高龄骨折患者围术期合并医院获得性肺炎相关因素的病例对照研究

目的探讨高龄骨折患者围术期合并医院获得性肺炎(HAP)的危险因素。方法采用病例对照研究的方法收集2008年10月至2012年10月中国人民解放军第四二一医院收治的老年骨折围术期合并HAP患者39例(HAP组),并随机选择同期老年骨折患者围术期不合并HAP患者39例(非HAP组),比较两组患者围术期各项临床指标的差异,行多因素Logistic回归分析。结果多因素Logistic回归分析结果显示:COPD(OR=23.317;95%CI:2.702⁶0.312;P=0.000)、入住ICU(OR=14.163;95%CI:1.62460.312;P=0.000)、入住ICU(OR=14.163;95%CI:1.624¹12.012;P=0.005)、机械通气(OR=30.210;95%CI:8.164112.012;P=0.005)、机械通气(OR=30.210;95%CI:8.164¹34.203;P=0.007)、手术时间(OR=9.018;95%CI:1.074134.203;P=0.007)、手术时间(OR=9.018;95%CI:1.074⁸8.119;P=0.022)为高龄骨折患者围术期合并HAP的独立危险因素。结论高龄骨折患者存在COPD、入住ICU、机械通气及手术时间长等因素时应警惕术后发生HAP的可能性。

Study on the Postoperative Risk Factors of Hospital-acquired Pneumonia in Patients with Senile Fractures

Objective To study the postoperative risk Factms of hospital-acquired pneumonia（HAP） in patients with senile fractures.Methods A total of 39 cases of senile fracture patients with hospital-acquired pneumonia admitted in No.421 H ospital of PLA from Oct.2008 to Oct.2012 were selected as H AP group,and another 39 cases of senile fracture patients with no HAP during the same period were selected as non-HAP group.The clinical indexes of the two groups during perioperative period were analyzed by muhivariate Logistic regression analysis.Results Results of muhivariate Logistic regression analysis showed：COPD（OR =23.317 ; 95 % CI：2.702-60.312 ; P =0.000）,ICU（OR =14.163 ; 95% CI：1.624-112.012 ; P =0.005）,mechanical ventilation（OR =30.210 ; 95% CI：8.164-134.203 ;P =0.007）,duration of operation （OR =9.018 ; 95 % CI：1.074-88.119 ; P =0.022）.Conclusion COPD,IC U,mechanical ventilation,duration of operation are the postoperative risk factors of hospital-acquired pneumonia in patients with senile fractures.