固定肋骨骨折对患有慢性阻塞性肺病的患者有益,这是创伤质量改善计划研究的研究结果
Chien-An Liao1,2,3, Chih-Po Hsu1,2, Jen-Fu Huang1,2
1Department of Trauma and Emergency Surgery, Linkou Medical Center, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Kwei-Shan District, Taoyuan, Taiwan.
Journal of orthopaedic surgery and research
|September 28, 2024
概括
在患有慢性阻塞性肺病 (COPD) 的患者中,用于肋骨骨折的内部固定是安全有效的. 手术干预可以提高死亡率,而不会增加术后并发症.
科学领域:
- 创伤外科 手术 创伤外科
- 肺部医学 肺部医学
- 关键的护理关键的护理
背景情况:
- 内部固定是多重肋骨骨折的标准治疗方法.
- 患有慢性阻塞性肺病 (COPD) 的患者面临更高的术后并发症风险.
- 在患有肋骨骨折的COPD患者中,内部固定的有效性和安全性尚不清楚.
研究的目的:
- 评估成年 COPD 患者多重肋骨骨折的内部固定结果.
- 为了比较手术和非手术治疗组之间的死亡率和不良医院事件.
主要方法:
- 从创伤质量改善计划 (2017-2019) 中确定了≥3个肋骨骨折和COPD的成年患者.
- 患者被分为手术和非手术组.
- 使用逆概率治疗权重来分析死亡率和医院不良事件.
主要成果:
- 治疗组使用呼吸机的比例较高 (OR,3.211;p<0.001),住院时间较长 (β,4.139;p<0.001),呼吸机使用日数较多 (β,1.937;p=0.003).
- 与非手术组相比,手术组的死亡率明显较低 (OR,0.426;p=0.008).
- 在手术组中没有观察到术后并发症的增加率.
结论:
- 肋骨骨折的内部固定对COPD患者有益.
- 在这个队列中,手术干预可以改善生存率,而不会增加术后并发症的风险.
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