股骨颈骨折患者影响手术治疗效果因素分析

目的探讨股骨颈骨折患者术后临床结局的影响因素。方法对180例股骨颈骨折患者的临床资料进行统计分析，记录所有患者的性别、年龄、血清白蛋白水平、血清Hb水平、受伤时间和手术时间的间隔时间、术前合并症及术前的身体状况，分析其对术后1年的临床结局的影响。结果死亡患者与存活患者的合并症（89．6％与10．4％）、身体状况分级（84．9％与15．1％）、Hb水平（98．4％与1．6％）、血清白蛋白水平（98．9％与1．1％）以及总淋巴细胞数目（96．6％与3．4％）之间差异均有统计学意义（X。=7．227、13．855、16．201、6．678、4．649，均P〈0．05）。经多因素Logistic回归分析，合并症〉2种、身体状况分级处于Ⅲ级或Ⅳ级、Hb水平〈100g／L、血清白蛋白水平〈35g／L以及总淋巴细胞数目〈1．5×10 9／L均为股骨颈骨折患者术后临床结局的危险因素。结论合并症、身体状况分级、Hb水平、血清白蛋白水平及总淋巴细胞数目为股骨颈骨折患者术后增加临床病死率的危险因素。

Study on the influencing factors of the clinical outcome of patients with femoral neck fracture

Objective To investigate the influencing factors of the clinical outcome of patients with femoral neck fracture after operation. Methods 180 patients with femoral neck fractures were chosen, the clinical data were statistical analyzed, recording body condition of concurrent disease and preoperative in all patients gender, age, level of hemoglobin, serum albumin level,injured time and operation time interval of time, before the operation, The influence of clinical outcome in patients of 1 years after fracture of neck was analyzed. Results The death patients and survival between patients with concurrent disease（89.6% vs 10.4% ）, physical status classification（84.9% vs 15.1% ）, hemoglobin（98.4% vs 1.6% ）,serum albumin level（98.9% vs 1.1% ） and total lymphocyte number（96.6% vs 3.4% ） had statistical significance（ x2 = 7. 227,13. 855,16. 201,6. 678,4. 649, all P 〈 0. 05 ）. Multivariate Logistic regression analysis, concurrent disease, 〉 2 physical status classification in the grade 11I or IV, level of hemoglobin 〈 lOOg/L,level of serum albumin 〈 35g/L and total lymphocyte number 〈 1.5 × 10 9/L were risk factors of clinical out- come of femoral neck after surgery. Conclusion Concurrent disease, physical status classification, hemoglobin levels, serum albumin level and total lymphocyte number are clinical risk factors increased mortality for patients with fracture of neck of femur.