老年股骨颈骨折关节置换术后生存现状及影响因素分析

目的分析老年股骨颈骨折病人关节置换术后生存现状及影响因素。方法老年股骨颈骨折124例均进行全髋关节置换术，收集对病人术后病死率的相关因素进行单因素分析，采用多因素logistic回归分析对单因素分析中有意义的项进行多因素分析。结果124例病人中失访4例，病死9例；所有病人髋关节Harris各维度评分随时间延长而上升（P < 0.05）；单因素分析中年龄、糖尿病、高血压、术后功能锻炼、血清白蛋白含量、血红白蛋白含量及淋巴细胞计数均与老年股骨颈骨折病人关节置换术后病死率具有相关性（P < 0.01）；多因素logistic回归分析结果显示，年龄、糖尿病、术后功能锻炼、血清白蛋白含量、血红蛋白含量及淋巴细胞计数均为老年股骨颈骨折病人关节置换术后病死率的独立影响因素（P < 0.01）。结论老年股骨颈骨折病人关节置换术后病死率受多种因素共同影响，临床上应根据这些危险因素制定出合理有效的解决方案。

Survival status and influencing factors of elderly patients with femoral neck fracture after joint replacement

ObjectiveTo analyze the survival status and influencing factors of elderly patients with femoral neck fracture after joint replacement.MethodsA total of 124 elderly patients with femoral neck fracture were treated with total hip replacement.The related factors of postoperative mortality were analyzed by univariate analysis, and the significant items in univariate analysis were analyzed by multivariate logistic regression analysis.ResultsAmong the 124 patients, 4 cases were lost to follow-up and 9 cases died.Harris hip score in each dimension increased with time going(P < 0.05).Univariate analysis showed that age, diabetes mellitus, hypertension, postoperative functional exercise, serum albumin content, hemoglobin content and lymphocyte count were correlated with the mortality of elderly patients with femoral neck fracture after joint replacement(P < 0.01).Multivariate logistic regression analysis showed that age, diabetes mellitus, postoperative functional exercise, serum albumin content, hemoglobin content and lymphocyte count were independent influencing factors of mortality in elderly patients with femoral neck fracture after joint replacement (P < 0.01).ConclusionsThe mortality of elderly patients with femoral neck fracture after joint replacement is affected by many factors, and reasonable and effective solutions should be formulated in clinic according to these risk factors.