【摘要】 目的探讨应用骨科手术风险评分对老年骨科病人手术风险评估的临床意义。方法回顾性分析2000年1月～2006年1月在我科住院手术的60岁以上老年髋部骨折病例资料260例，根据患者入院后至手术前的化验结果、心肺功能评估、测量血压值等作为风险因子，分别给予赋值，建立评分系统。将260例接受手术治疗的病人根据术前评分多少分为低风险组、中风险组、高风险组和极高风险组。观察评分与术后死亡及并发症发生情况的相关性。结果低风险组90例，评分为(14.5±0.8)分，住院期间无死亡病例，出现并发症14例;中风险组73例，评分为(18.6±2.2)分，住院期间无死亡病例，出现并发症26例;高风险组65例，评分为(24.3±2.9)分，住院期间死亡2例，出现并发症30例;极高风险组32例，评分为(27.8±4.7)分，住院期间死亡4例，出现并发症28例。结论根据老年病人住院后的化验检查、合并症等情况作为手术风险因子而自行设计的简易评分能够较准确地评估老年髋部骨折的预后情况。
【关键词】 髋部骨折;术前评估;并发症;老年
Retrospective analysis of operative risk score for orthopedics surgery in elderly patients with hip fracture in 260 cases
LAN Xiufu，WANG Aimin，SUN Hongzhen,et al.
Department of Orthopedics,Institute of Surgery Research,Daping Hospital,Third Military Medical University, Chongqing400042,China
Abstract:ObjectiveTo discuss the clinical significance of assessing operation risk of old orthopedics patients by orthopedics surgery risk score.MethodsRetrospective analysis of 260 patients(aged over 60 years old) with hip fractures admitted from Jan.2000 to Jan.2006 were performed.The scoring system was built on the assignment which were set according to the risk factors involving the laboratory examination results before operation,cardiorespiratory function and blood pressure.The 260 patients were divided into low risk group,middle risk group,high risk group and extremely high risk group according to the scores evaluated before operation.ResultsThe low risk group included 90 patients with the risk score(14.5±0.8) in which 14 patients had complication and no patients died in the duration of hospital stay.The middle risk group included 73 patients with the risk score(18.6±2.2) in which 26 patients had complication and no patients died in the duration of hospital stay.The high risk group included 65 patients with the risk score(24.3±2.9) in whick 30 patients had complication and 2 patients died in the duration of hospital stay.The extremely high risk group in
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