摘要
目的:探讨影响髋关节置换术后并发症的危险因素。方法:收集2016年2月—2018年7月在我院行髋关节置换术的114例患者的临床资料,根据患者术后临床结局分为并发症组29例、无并发症组85例。比较两组患者的一般临床资料及术后并发症。采用多元逐步Logisitic回归分析筛选影响患者临床结局的独立危险因素,并构建列线图预测模型进行验证。结果:两组性别、吸烟史、饮酒史差异无统计学意义(P>0.05),两组年龄、体质指数(BMI)、糖尿病、高血压、手术时间、住院时间、术后搬运不当、长期应用激素、输血、术后C反应蛋白(CRP)差异有统计学意义(P<0.05)。多元逐步Logistic分析结果显示,年龄≥60岁、BMI≥24 kg/m^(2)、糖尿病、手术时间≥2 h、住院时间≥15 d、术后搬运不当、输血过多、术后CRP≥10 mg/L是影响髋关节置换术后发生并发症的独立危险因素(P<0.05)。列线图预测模型经Bootstrap法重复抽样进行内部验证和外部验证,C指数分别为0.817和0.795,区分度较好。结论:年龄大、BMI大、有糖尿病、手术时间长、住院时间长、术后搬运不当、输血过多、术后CRP大是影响髋关节置换术后发生并发症的独立危险因素。预测术后并发症发生风险的列线图模型具有良好的区分度与准确度,临床工作中应考虑对这些因素进行针对性防控,以降低髋关节置换术后并发症的发生率。
Objective To explore the risk factors that affect the complications after hip replacement.Methods The clinical data of 114 patients who underwent hip arthroplasty in our hospital from February 2016 to July 2018 were collected,and the patients were divided into complication group and non-complication group according to the postoperative clinical outcome.The correlation between the general clinical data of the two groups of patients and postoperative complications were compared.Multivariate stepwise logisitic regression analysiswere used to screen the factors affecting the clinical outcome of patients,and the independent risk factors screened out were constructed and verified by a nomogram prediction model.Results Multivariate stepwise logisitic regression analysis showed that age,diabetes,body mass index(BMI),operation time,hospital stay,improper postoperative handling,excessive blood transfusion,postoperative C-reaction protein(CRP)are independent risk factors for complications after hip replacement(P<0.05).After repeated sampling by Bootstrap method for internal verification and external verification,the C-indexes were 0.817 and 0.795 respectively and the discrimination was good.Conclusion Age,diabetes,BMI,operating time,length of stay,improper postoperative handling,excessive blood transfusion and postoperative CRP factors are independent risk factors for complications after hip replacement.Based on these,the nomogram model for predicting the risk of postoperative complications has good discrimination and accuracy.These factors should be considered in clinical work.These factors should also be prevented and controlled to reduce the incidence of complications after hip replacement.
作者
李军
封挺
陈云辉
刘霞
王永胜
LI Jun;FENG Ting;CHEN Yun-hui(Department of Orthopedics,Guangzhou Panyu Central Hospital,Guangzhou(511400),China)
出处
《中国中西医结合外科杂志》
CAS
2021年第6期826-830,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
广州市卫生健康科技项目2019年度西医类一般引导项目(20191A010079)。
关键词
髋关节置换术
并发症
危险因素
多元Logisitic回归
Hip replacement surgery
complications
risk factors
multivariate stepwise logisitic regression analysis
