| 张阿锋,朱伟东,刘文雄,高怀新.高龄髋部骨折患者慢性术后疼痛危险因素分析[J].老年医学与保健,2025,31(6):1518-1522 |
| 高龄髋部骨折患者慢性术后疼痛危险因素分析 |
| Analysis of risk factors for chronic post-surgical pain in advanced age patients with hip fractures |
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| DOI：10.3969/j.issn.1008-8296.2025.06.020 |
| 中文关键词: 高龄患者 髋部骨折 股骨转子间骨折 慢性术后疼痛 危险因素 |
| 英文关键词: advanced age hip fracture femoral intertrochanteric fracture chronic post-surgical pain risk factor |
| 基金项目:L2024-ZDYF-ZDYF-SF-0029:咸阳市重点研发计划 |
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| 中文摘要: |
| 目的 探究高龄髋部骨折患者慢性术后疼痛(CPSP)的危险因素.方法 回顾性分析2017 年1 月至2024 年12月西电集团医院单侧髋部骨折行手术治疗的高龄患者(年龄≥85 岁)临床资料.根据患者术后12 个月是否存在CPSP分为CPSP组(n=71)和无CPSP组(n=205).比较2 组的一般资料﹑围手术期资料和术后实验室检查结果,二元Logistic回归探讨高龄髋部骨折手术患者CPSP的影响因素.结果 研究纳入276 例高龄髋部骨折手术患者,年龄85～99 岁,平均(87.8±2.8)岁,其中男性100 例、女性176 例,71 例(25.72%)患者发生CPSP.与无CPSP组相比,CPSP组髋关节置换术构成比较高,手术时间较长,术后降钙素原和白细胞介素-6(IL-6)水平较高,差异有统计学意义(P＜0.05).二元Logistic 回归分析显示,体质量指数(BMI)升高(OR=1.006,95%CI:1.002～1.011,P＜0.05)﹑股骨转子间骨折(OR=1.505,95%CI:0.439～1.581,P＜0.001)﹑髋关节置换术(OR=2.029,95%CI:1.729～2.380,P＜0.001)﹑术后IL-6 水平升高(OR=1.124,95%CI:1.019～1.214,P＜0.05)是高龄髋部骨折手术患者CPSP的危险因素;术后血红蛋白(Hb)水平升高(OR=0.946,95%CI:0.928～0.964,P＜0.001)是高龄髋部骨折手术患者CPSP的保护因素.结论 BMI升高、股骨转子间骨折﹑髋关节置换术、术后IL-6 水平升高可能是高龄髋部骨折手术患者CPSP的危险因素,术后Hb水平升高可能是高龄髋部骨折手术患者CPSP的保护因素. |
| 英文摘要: |
| Objective To investigate the risk factors for chronic post-surgical pain(CPSP)in advanced age patients after hip fracture surgery.Methods A retrospective analysis was conducted on the clinical data of advanced age patients(age≥85 years)who underwent surgical treatment for unilateral hip fracture in Xidian Group Hospital between January 2017 and December 2024.The patients were divided into CPSP group(n=71)and non-CPSP group(n=205)based on whether they had CPSP 12 months after the operation.The general data,perioperative data and postoperative laboratory test results of the two groups were compared.Binary Logistic regression was used to identify influencing factors for CPSP in advanced age patients undergoing hip fracture surgery.Results This study included 276 advanced age patients who underwent hip fracture surgery,aged 85-99 years(mean 87.8±2.8),including 100 males and 176 females.A total of 71 patients(25.72%)developed CPSP.Compared with the non-CPSP group,the CPSP group had a significantly higher proportion of patients who underwent hip arthroplasty,longer surgical duration,and higher postoperative levels of procalcitonin and interleukin-6(IL-6)(P＜0.05).Binary Logistic regression analysis revealed that increased body mass index(BMI)(OR=1.006,95%CI:1.002-1.011,P＜0.05),femoral intertrochanteric fracture(OR=1.505,95%CI:0.439-1.581,P＜0.001),hip arthroplasty(OR=2.029,95%CI:1.729-2.380,P＜0.001),and elevated postoperative IL-6 level(OR=1.124,95%CI:1.019-1.214,P＜0.05)were risk factors for CPSP.Conversely,increased postoperative hemoglobin(Hb)level(OR=0.946,95%CI:0.928-0.964,P＜0.001)was a protective factor.Conclusion Increased BMI,femoral intertrochanteric fracture,hip arthroplasty,and elevated postoperative IL-6 level may be risk factors for CPSP in advanced age patients after hip fracture surgery,while an increased postoperative Hb level may be a protective factor. |
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