【摘要】 目的探讨髋关节手术患者术后肺炎(POP)的危险因素,评价倾向性评分匹配(PSM)在回顾性资料处理中的应用价值。方法收集某院骨关节科自2018年1月1日—2019年12月31日共1 141例髋关节手术患者的资料,应用倾向性评分(PS)对髋关节术后患者资料进行分析。结果 1 141例髋关节手术患者出现POP共102例,发生率为8.94%.PSM前,骨折患者和未骨折患者POP发生率比较,差异无统计学意义(P>0.05)。PSM前,骨折患者和未骨折患者的性别、年龄、麻醉方式、谵妄痴呆、ASA分级、恶性肿瘤、糖尿病、心血管病的8个协变量比较,差异均有统计学意义(均P<0.05)。PSM后,以上8个协变量在两组间分布都达到均衡(均P>0.05)。经过logistic多因素分析显示:年龄>65岁、有慢性阻塞性肺疾病的病史、骨折是髋关节手术患者发生POP的独立危险因素(均P<0.05);与全身麻醉比较,椎管内麻醉是髋关节手术患者发生POP的独立保护因素(P<0.05)。结论 PSM法能有效降低观察性研究组间的混杂偏倚。骨折是引起髋关节手术患者POP的危险因素之一。更多还原

【Abstract】 Objective To evaluate the risk factors for post-operative pneumonia(POP) in patients undergoing hip joint surgery, evaluate the application value of propensity score matching(PSM) in processing of retrospective data. Methods Data of 1 141 patients undergoing hip joint surgery from January 1, 2018 to December 31, 2019 in the department of orthopedics and joint surgery of a hospital were collected, data of patients after hip joint surgery were analyzed by propensity score. Results There were 102 cases of POP among 1 141 hip joint surgery patients, incidence was 8.94%. Before PSM, there was no significant difference in POP incidence between fracture patients and non-fracture patients(P>0.05). Before PSM, there were significant differences in 8 covariates, including gender, age, anesthesia, delirium and dementia, ASA classification, malignant tumor, diabetes and cardiovascular disease between fracture patients and non-fracture patients(all P<0.05). After PSM, distribution of the above 8 covaria-tes reached equilibrium between two groups(all P>0.05). Logistic multivariate analysis showed that age>65 years old, history of chronic obstructive pulmonary disease and fracture were independent risk factors for POP in hip joint surgery patients(all P<0.05); compared with general anesthesia, intravertebral anesthesia was an indepen-dent protective factor for POP in hip joint surgery patients(P<0.05). Conclusion PSM method can effectively reduce the confounding bias among groups in observational study. Fracture is one of the risk factors for POP in hip joint surgery patients.更多还原