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中国临床研究:2020,33(5):626-629
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急诊骨科手术患者术后并发症相关危险因素的回顾性分析
(南京大学医学院附属鼓楼医院麻醉科,江苏 南京210008)
Retrospective analysis of risk factors related to complications after emergency orthopaedic surgery
(Department of Anesthesiology,Nanjing Drum Tower Hospital,Nanjing,Jiangsu 210008,China)
摘要
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投稿时间:2019-11-12   网络发布日期:2020-05-20
中文摘要: 目的 探讨急诊骨科手术患者术后并发症的相关危险因素。方法 回顾性分析2017年7月至2019年7月于南京大学医学院附属鼓楼医院接受急诊骨科手术的228例患者的临床资料,分别采集患者人口学资料、术前合并症、麻醉方式、手术名称、手术时间、出入量、术中不良事件以及术后并发症的发生情况,采用单因素分析探讨各临床指标与术后并发症的相关性,采用多因素Logistic回归模型分析术后并发症的危险因素。结果 纳入228例患者中24例(10.5%)在住院期间发生术后主要系统并发症,以切口相关并发症为主(37.5%),其次是呼吸系统并发症(29.2%)和心血管系统并发症(20.8%)。年龄(OR=1.983,95%CI:1.754~2.112,P<0.01)、ASA分级(OR=1.597,95%CI:1.005~2.208,P<0.01)和术中低血压持续时间(OR=2.306,95%CI:1.514~3.070,P<0.01)是术后并发症发生的独立影响因素。结论 年龄、ASA分级与术中低血压持续时间均可作为急诊骨科手术患者术后并发症的预警因素,此类患者的麻醉管理应尽量维持血流动力学的平稳,以降低术后并发症的发生风险。
Abstract:ObjectiveTo explore the risk factors of complications after emergency orthopaedic surgery.MethodsThe clinical data of 228 patients undergoing emergency orthopaedic surgery in Nanjing Drum Tower Hospital from July 2017 to July 2019 were retrospectively analyzed.The demographic data,preoperative concurrent diseases,anesthesia mode,operation type,operation time,infusion volume,blood loss,adverse events during operation and complications after surgery were collected.Univariate analysis was applied to explore the relationship between these clinical indicators and postoperative complications,and multivariate logistic regression model was used to analyze the risk factors of postoperative complications.ResultsIn 24 patients (10.5%) with major complications after operation,incision-related complications,respiratory complications and cardiovascular complications accounted for 37.5%,29.2% and 20.8%,respectively. Multivariate logistic regression model showed that age(OR=1.983,95%CI:1.754-2.112,P<0.01),American Society of Anesthesiologists (ASA) level (OR=1.597,95%CI:1.005-2.208,P<0.01) and intraoperative hypotension (OR=2.306,95%CI:1.514-3.070,P<0.01) were the independent risk factors for postoperative complications.ConclusionsAge,ASA level and intraoperative hypotension can be used as early warning [JP2]indicators for post-operative complications in patients receiving emergency orthopaedic surgery.Hemodynamic stability should be maintained as far as possible for anesthesia management in patients,to reduce the risk of post-operative complications.
文章编号:     中图分类号:    文献标志码:B
基金项目:国家自然科学基金(81771142,81870875);江苏省“六大人才高峰”(YY-077,YY-084);江苏省青年医学人才(QNRC2016014)
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引用文本:
刘玥,宋芬,张伟,顾小萍,马正良.急诊骨科手术患者术后并发症相关危险因素的回顾性分析[J].中国临床研究,2020,33(5):626-629.

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