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2种不同麻醉方法对髋部骨折老年患者术后肺部并发症发生的多因素分析
其他题名Effects of General Anesthesia and Combined Spinal Epidural Anesthesia on Postoperative Pulmonary Complications After Hip Fracture Surgery in Elderly Patients:a Multiple Factors Analysis
魏滨; 张华; 王军; 张利萍; 郭向阳; 李民; 周方
关键词髋部骨折 麻醉 肺部并发症 Hip fracture Anesthesia Pulmonary complication
刊名中国微创外科杂志
2015
DOI10.3969/j.issn.1009-6604.2015.04.001
4页:289-292
收录类别中国科技核心期刊 ; CSCD
文章类型Journal Article
摘要目的:探讨全身麻醉( general anesthesia , GA )和硬膜外联合蛛网膜下腔麻醉( combined spinal epidural anesthesia, CSEA)对髋部骨折老年病人术后肺部并发症的影响。方法选择我院2005年1月~2014年12月髋部骨折接受手术治疗的老年病人469例,其中300例接受CSEA(CSEA组),169例接受GA(GA组),先对病人年龄、性别、术前内科合并症、卧床时间、手术和麻醉方式进行单因素分析,有统计学差异的因素再采用多重logistic回归模型分析老年髋部骨折病人术后肺部并发症的影响因素。结果48例发生术后肺部并发症,其中CSEA组13例,GA组35例。单因素分析显示年龄、术前卧床时间和麻醉方式有统计学差异(P<0.05),性别、ASA分级和内科合并症无统计学差异(P>0.05)。多重logistic回归分析显示CSEA可以降低髋部骨折老年病人的术后肺部并发症( OR=0.17,95% CI:0.08~0.31,P=0.000);80~84岁(OR=5.09,95%CI:1.74~14.86,P=0.003)、85岁以上(OR=5.27,95% CI:1.71~16.17,P=0.004)和术前卧床2 d以上(OR=2.41,95%CI:1.04~5.56,P=0.040)是发生术后肺部并发症的危险因素。结论 CSEA较GA可以降低髋部骨折老年病人的术后肺部并发症。 Objective To study the effects of general anesthesia ( GA) and combined spinal epidural anesthesia ( CSEA) on postoperative pulmonary complications after hip fracture surgery in elderly patients . Methods A total of 469 eldly patients undergoing surgery for hip fracture were selected , including 300 patients receiving CSEA and 169 patients receiving GA .After univariate analysis on age , gender, preoperative co-morbidities, bedridden time, and methods of operation and anesthesia , a multiple logistic regression analysis was carried out on statistically different factors to observe influencing factors of postoperative pulmonary complications in elderly patients . Results Postoperative pulmonary complications occurred in 48 patients (10.2%).Univariate analysis showed that the independent variables on postopeative pulmonary complications were age , bedridden time, and anesthesia (P<0.05).Other factors, such as gender,ASA classification, and preoperative co-morbidities, had no statistical significance (P>0.05). Combined spinal epidural anesthesia was associated with a lower odds of pulmonary complications ( OR=0.17, 95%CI:0.08-0.31, P=0.000) as compared to general anesthesia .The age group of 80-84 years old (OR=5.09, 95%CI:1.74-14.86, P=0.003), over 85 years old (OR=5.27, 95%CI:1.71-16.17, P=0.004), and bedridden time more than 2 days (OR=2.41, 95%CI:1.04-5.56, P=0.040 ) were also the risk factors of postoperative pulmonary complications . Conclusion Combined spinal epidural anesthesia is associated with a lower odds of pulmonary complications in hip fracture patients as compared with general anesthesia .
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/72296
Collection北京大学第三临床医学院_麻醉科
作者单位1.北京大学第三医院麻醉科,北京,100191
2.北京大学第三医院临床流行病学研究中心,北京,100191
3.北京大学第三医院骨科,北京,100191
Recommended Citation
GB/T 7714
魏滨,张华,王军,等. 2种不同麻醉方法对髋部骨折老年患者术后肺部并发症发生的多因素分析[J]. 中国微创外科杂志,2015(4):289-292.
APA 魏滨.,张华.,王军.,张利萍.,郭向阳.,...&周方.(2015).2种不同麻醉方法对髋部骨折老年患者术后肺部并发症发生的多因素分析.中国微创外科杂志(4),289-292.
MLA 魏滨,et al."2种不同麻醉方法对髋部骨折老年患者术后肺部并发症发生的多因素分析".中国微创外科杂志 .4(2015):289-292.
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