高龄髋部骨折患者术后发生脑卒中危险因素分析
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作者Author单位AddressE-Mail
辛红伟 XIN Hong-wei 开封市中心医院骨科一病区, 河南 开封 475003 The First Ward of Orthopedics Department,Kaifeng Central Hospital,Kaifeng 475003,Henan,China  
期刊信息:《中国骨伤》2022年,第35卷,第4期,第337-341页
DOI:10.12200/j.issn.1003-0034.2022.04.007
基金项目:
中文摘要:

目的: 探讨高龄髋部骨折患者术后发生脑卒中的危险因素。

方法: 自2012年3月至2017年6月接受髋关节置换术的高龄髋部骨折的500例患者,男286例,女214例;年龄60~76(68.49±11.85)岁。根据术后2周内是否发生急性脑卒中分为卒中组30例及对照组470例。比较两组患者一般资料及血清细胞因子白细胞介素(interleukin,IL)-1,IL-6,IL-10,肿瘤坏死因子-α(tumer necrosis factors,TNF-α)的含量,随访两组患者的总体生存情况。

结果: 卒中组患者的性别、年龄、麻醉方式、手术时间、术中失血量、及术前IL-1、IL-6、IL-10、TNF-α含量与对照组比较差异无统计学意义(P>0.05),高血压、糖尿病、房颤的患病率、术中低血压的发生率以及术后1、3 d时的血清IL-1、IL-6、IL-10、TNF-α含量均明显高于对照组(P<0.05)。截止至随访日期,卒中组患者的累积生存率明显低于对照组(P<0.05)。经Logistic回归分析:房颤,术中低血压,术后1、3 d时血清IL-1及TNF-α含量升高是术后急性脑卒中的危险因素。

结论: 高龄髋部骨折患者手术后脑卒中的发生影响疾病预后,术后炎症细胞因子IL-1、TNF-α的增多是脑卒中发生的独立危险因素。
【关键词】髋骨折  卒中  危险因素
 
Risk factors of postoperative stroke in elderly patients with hip fracture
ABSTRACT  

Objective: To study the risk factors of stroke after of elderly patients with hip fracture after operation.

Methods: From March 2012 to June 2017,500 elderly patients with hip fracture who underwent hip replacement were selected,including 286 males and 214 females,aged from 60 to 76 years old with an average of (68.49±11.85) years. They were divided into stroke group with 30 cases and control group with 470 cases according to the occurrence of acute stroke within two weeks after operation. The general data and serum contents of cytokines IL-1,IL-6,IL-10 and TNF-α were compared between the two groups. The overall survival of the two groups were followed up.

Results: There was no significant difference in sex,age,anesthesia method,operation time,intraoperative blood loss,preoperative IL-1,IL-6,IL-10 and TNF-α contenta between stroke group and control group(P>0.05). The prevalence of hypertension,diabetes mellitus,atrial fibrillation,intraoperative hypotension,IL-1,IL-6,IL-10 and TNF-α contenta 1 day and 3 days after operation of stroke group were significantly higher than control group(P<0.05);up to the date of follow-up,the cumulative survival rate of stroke patients were significantly lower than those of the control group(P<0.05). Logistic regression analysis showed that intraoperative hypotension,elevated contents of serum IL-1 and TNF-α at 1 and 3 days after operation were risk factors for acute stroke.

Conclusion: Postoperative stroke in elderly patients with hip fracture affects the prognosis of the disease. The increase of inflammatory cytokines IL-1 and TNF-α after operation is an independent risk factor for stroke.
KEY WORDS  Hip fractures  Stroke  Risk factors
 
引用本文,请按以下格式著录参考文献:
中文格式:辛红伟.高龄髋部骨折患者术后发生脑卒中危险因素分析[J].中国骨伤,2022,35(4):337~341
英文格式:XIN Hong-wei.Risk factors of postoperative stroke in elderly patients with hip fracture[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(4):337~341
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