高能量Pilon骨折手术疗效的影响因素分析
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摘要
目的：
通过回顾性分析高能量Pilon骨折患者的年龄、性别、学历、收入、骨折分型、手术时机、手术方式、骨折复位质量、术后并发症、术后功能锻炼时机与术后踝关节功能的关系,为日后提高高能量Pilon骨折的手术疗效提供临床证据及参考。
方法：
通过中南大学湘雅二医院病历检索系统检索2008年1月至2009年12月住院患者中明确诊断为Pilon骨折且符合本次研究纳入标准的病历45例。经回访,记录患者的年龄、性别、学历、收入、骨折分型、手术时机、手术方式、骨折复位质量、术后并发症、术后功能锻炼时机,并作出Mazur踝关节功能评分。采用SPSS Statistics19.0统计软件对数据进行分析,先行单因素两样本均数t检验及方差分析(ANOVA),P<0.05为有统计学意义,再以单因素分析中有统计学意义的影响因素为自变量,以Mazur踝关节功能评分为因变量,采用逐步回归法(α入=0.05,α出=0.10)建立多元线性回归方程。
结果：
符合入组条件的45例病例中共41例获得回访并完成踝关节功能评价,回访率91.1%。单因素分析中,Mazur踝关节评分差异有统计学意义的影响因素为：年龄(P=0.012<0.05),学历(P=0.012<0.05),骨折分型(P=0.019<0.05),骨折复位质量(P=0.0001<0.05),术后功能锻炼时机(P=0.00001<0.05)。故在多元线性回归分析中,以患者年龄、学历、骨折分型、骨折复位质量、术后功能锻炼时机为自变量,以Mazur踝关节功能评分为因变量进行分析,最终骨折复位质量、骨折分型及术后功能锻炼时机三个自变量选入方程,回归方程为：
Y=70.586+4.060X3-3.562X4+11.585X5。
结论：
对于高能量Pilon骨折,骨折分型、骨折复位质量、术后功能锻炼时机是术后踝关节功能的影响因素。
Objective:
Retrospectively analysis the relations between patients'age, gender, education, income, fracture types, timing for surgery, surgery techniques, quality of fracture reduction, complications, timing for postoperative functional exercise and ankle function to guide daily clinical work.
Methods:
Select45cases of tibia Pilon fracture cured from January2008to December2009in the department of Orthopedics in the Second XiangYa Hospital of Central South University, through the computer-based patient record system. By reviewing the records, the age, gender, education, income, fracture types, surgery techniques, timing for surgery, quality of fracture reduction, complications, timing for postoperative functional exercise of patients were taken notes in detail. The patients were called back to the hospital to complete Mazur ankle function scoring questionnaire. All of the data were analyzed by SPSS19.0statistical software for windows, with multiple linear regression to reveal the influencing factors affecting the ankle function.
Results:
41of respondents were reinterviewed and evaluated Mazur ankle function score, with a91.1%reinterview rate. The parameters of the age, gender, education, income, fracture types, surgery techniques, timing for surgery, quality of fracture reduction, complications, timing for postoperative functional exercise of patients were analyzed to establish a statistic model by means of multiple linear regression, which showed that the P values of quality of fracture reduction, fracture type, timing for postoperative functional exercise were statistically significant (P<0.05). The regression equation was Y=70.586+4.060X3-3.562X4+11.585X5.
Conclusion:
Quality of fracture reduction, fracture type, timing for postoperative functional exercise are the influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture.
通过回顾性分析高能量Pilon骨折患者的年龄、性别、学历、收入、骨折分型、手术时机、手术方式、骨折复位质量、术后并发症、术后功能锻炼时机与术后踝关节功能的关系,为日后提高高能量Pilon骨折的手术疗效提供临床证据及参考。
方法：
通过中南大学湘雅二医院病历检索系统检索2008年1月至2009年12月住院患者中明确诊断为Pilon骨折且符合本次研究纳入标准的病历45例。经回访,记录患者的年龄、性别、学历、收入、骨折分型、手术时机、手术方式、骨折复位质量、术后并发症、术后功能锻炼时机,并作出Mazur踝关节功能评分。采用SPSS Statistics19.0统计软件对数据进行分析,先行单因素两样本均数t检验及方差分析(ANOVA),P<0.05为有统计学意义,再以单因素分析中有统计学意义的影响因素为自变量,以Mazur踝关节功能评分为因变量,采用逐步回归法(α入=0.05,α出=0.10)建立多元线性回归方程。
结果：
符合入组条件的45例病例中共41例获得回访并完成踝关节功能评价,回访率91.1%。单因素分析中,Mazur踝关节评分差异有统计学意义的影响因素为：年龄(P=0.012<0.05),学历(P=0.012<0.05),骨折分型(P=0.019<0.05),骨折复位质量(P=0.0001<0.05),术后功能锻炼时机(P=0.00001<0.05)。故在多元线性回归分析中,以患者年龄、学历、骨折分型、骨折复位质量、术后功能锻炼时机为自变量,以Mazur踝关节功能评分为因变量进行分析,最终骨折复位质量、骨折分型及术后功能锻炼时机三个自变量选入方程,回归方程为：
Y=70.586+4.060X3-3.562X4+11.585X5。
结论：
对于高能量Pilon骨折,骨折分型、骨折复位质量、术后功能锻炼时机是术后踝关节功能的影响因素。
Objective:
Retrospectively analysis the relations between patients'age, gender, education, income, fracture types, timing for surgery, surgery techniques, quality of fracture reduction, complications, timing for postoperative functional exercise and ankle function to guide daily clinical work.
Methods:
Select45cases of tibia Pilon fracture cured from January2008to December2009in the department of Orthopedics in the Second XiangYa Hospital of Central South University, through the computer-based patient record system. By reviewing the records, the age, gender, education, income, fracture types, surgery techniques, timing for surgery, quality of fracture reduction, complications, timing for postoperative functional exercise of patients were taken notes in detail. The patients were called back to the hospital to complete Mazur ankle function scoring questionnaire. All of the data were analyzed by SPSS19.0statistical software for windows, with multiple linear regression to reveal the influencing factors affecting the ankle function.
Results:
41of respondents were reinterviewed and evaluated Mazur ankle function score, with a91.1%reinterview rate. The parameters of the age, gender, education, income, fracture types, surgery techniques, timing for surgery, quality of fracture reduction, complications, timing for postoperative functional exercise of patients were analyzed to establish a statistic model by means of multiple linear regression, which showed that the P values of quality of fracture reduction, fracture type, timing for postoperative functional exercise were statistically significant (P<0.05). The regression equation was Y=70.586+4.060X3-3.562X4+11.585X5.
Conclusion:
Quality of fracture reduction, fracture type, timing for postoperative functional exercise are the influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture.
引文
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