衰弱及营养风险对初次髋关节置换术并发症的影响因素分析
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作者Author单位AddressE-Mail
马成才 MA Cheng-cai 亳州市人民医院骨科, 安徽 亳州 236800 Department of Orthopaedics, People's Hospital of Bozhou City, Bozhou 236800, Anhui, China 151567750@163.com 
李小娜 LI Xiao-na 亳州市人民医院骨科, 安徽 亳州 236800 Department of Orthopaedics, People's Hospital of Bozhou City, Bozhou 236800, Anhui, China  
张琪琪 ZHANG Qi-qi 亳州市人民医院骨科, 安徽 亳州 236800 Department of Orthopaedics, People's Hospital of Bozhou City, Bozhou 236800, Anhui, China  
丁超 and DING Chao 亳州市人民医院骨科, 安徽 亳州 236800 Department of Orthopaedics, People's Hospital of Bozhou City, Bozhou 236800, Anhui, China  
期刊信息:《中国骨伤》2022年,第35卷,第12期,第1154-1158页
DOI:10.12200/j.issn.1003-0034.2022.12.009
基金项目:
中文摘要:

目的:分析衰弱及营养风险与初次髋关节置换术并发症的关系,影响初次髋关节置换术并发症的危险因素。

方法:回顾性分析2019年1月至2021年1月接受髋关节置换术100例患者的临床资料,男36例,女64例;年龄18~85(73.82±4.04)岁。采用改良衰弱指数评估术后患者的衰弱状况,临床生化指标及NRS2002营养风险评估量表评估术后患者的营养状况,根据改良衰弱指数将100例患者分为衰弱组和非衰弱组,根据营养状况将100例患者分为营养正常组和营养风险组,并分析衰弱、营养风险与初次髋关节置换术后并发症的关系。

结果:衰弱组和非衰弱组的年龄、体质量指数(body mass index,BMI)、合并症、美国麻醉医师协会(Amercican Scociety of Anesthesiologists,ASA)分级比较,差异有统计学意义(P<0.05)。营养正常组和营养风险组的年龄、BMI、合并症、ASA分级比较,差异有统计学意义(P<0.05)。有35例患者发生至少1个术后并发症,其中肺部感染发生率最高,占34.29%(12/35);其次为泌尿感染,占22.86%(8/35)。单因素Logistic回归分析显示,年龄、BMI、ASA分级、合并症、衰弱及营养风险为影响术后并发症的危险因素。多因素Logistic回归分析显示,有合并症、衰弱及营养风险为影响术后并发症的独立因素。

结论:有合并症、衰弱、存在营养风险者可增加并发症发生概率,及时评估及识别上述患者,制定针对性干预措施,具有重要临床意义。
【关键词】衰弱  关节成形术,置换,髋  手术后并发症  影响因素分析
 
Influence factors of debilitating and nutritional risk on complications of primary hip replacement
ABSTRACT  

Objective: To analyze relationship of debilitating and nutritional risk on complications of primary hip replacement, and risk factors of influence of complications of primary hip replacement.

Methods: Totally 100 patients who underwent hip replacement from January 2019 to January 2021 were retrospectively analyzed, including 36 males and 64 females, aged from 18 to 85 years old with an average of (73.82±4.04) years old. Postoperative frailty status was evaluated by modified frailty index, and nutritional status was evaluated by clinical biochemical indexes and NRS2002 nutritional risk assessment scale. One hundred patients were divided into frailty group and non-frailty group according to modified frailty index, 100 patients were divided into normal nutrition group and nutritional risk group according to nutritional status, and relationship between frailty, nutritional risk and complications after primary hip replacement was analyzed.

Results: There were significant differences in age, body mass index (BMI), complications and ASA grade between frailty group and non-frailty group(P<0.05). There were statistically significant differences in age, BMI, complications and ASA grade between normal nutrition group and nutritional risk group (P<0.05). Thirty-five patients occurred at least one postoperative complications, and the incidence of pulmonary infection was the highest, accounting for 34.29% (12/35). The second was urinary infection, accounting for 22.86%(8/35). Univariate Logistic regression analysis showed that age, BMI, ASA grade, complications, frailty and nutritional risk were the risk factors for postoperative complications. Multivariate Logistic regression analysis showed that complications, frailty and nutritional risk were independent factors affecting postoperative complications.

Conclusion: Patients with comorbidities, frailty and nutritional risk could increase the incidence of complications. Timely assessment and identification of these patients in time, and formulation of targeted intervention measures have great clinical significance.
KEY WORDS  Frailty  Arthroplasty,replacement,hip  Postoperative complications  Root cause analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:马成才,李小娜,张琪琪,丁超.衰弱及营养风险对初次髋关节置换术并发症的影响因素分析[J].中国骨伤,2022,35(12):1154~1158
英文格式:MA Cheng-cai,LI Xiao-na,ZHANG Qi-qi,and DING Chao.Influence factors of debilitating and nutritional risk on complications of primary hip replacement[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(12):1154~1158
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