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目的调查分析儿童意外骨折后并发症的发生率及其相关危险因素,为临床预防并发症的发生提供参考。方法选取2010年1月-2013年3月期间在湖南省儿童医院接受诊治的447例意外骨折的儿童患者作为研究对象,调查骨折治疗后并发症发生率并分析其相关危险因素。结果 447名骨折患儿中共发生并发症53例,发生率为11.9%。女孩的并发症发生率为19.5%,高于男孩的9.1%(χ2=28.714,P=0.000),3~6岁儿童骨折的并发症发生率为17.4%,高于其他年龄组(χ2=27.661,P=0.000),农村地区发生骨折的儿童并发症发生率为8.9%,显著低于城镇儿童的18.8%(χ2=30.283,P=0.000);经多因素非条件Logistic回归分析,小心过度(OR=2.005,95%CI=1.179~5.912)、年龄(OR=1.316,95%CI=1.011~2.529)、溺爱(OR=1.316,95%CI=1.088~2.915)和父母文化水平(OR=1.072,95%CI=1.004~1.980)为骨折患儿并发症发生的主要危险因素;遵医嘱及时康复锻炼(OR=0.511,95%CI=0.221~0.810)为骨折患儿并发症发生的保护因素。结论儿童意外骨折的主要并发症为缺血性肌痉挛和神经麻痹,小心过度、年龄、家庭溺爱及父母文化为主要危险因素,遵医嘱及时康复锻炼是保护因素。
Objective To investigate the incidence of postoperative complications and related risk factors after accidental fracture in children and provide reference for the prevention of complications in clinical practice. Methods A total of 447 children with unexpected fractures admitted to Children’s Hospital of Hunan Province from January 2010 to March 2013 were selected as the research object to investigate the incidence of complications after fracture treatment and to analyze the related risk factors. Results A total of 447 children with fractures occurred in 53 cases of complications, the incidence was 11.9%. The incidence of complications was 19.4% in girls and 9.1% in boys (χ2 = 28.714, P = 0.000). The incidence of complications in children aged 3-6 years was 17.4%, higher than those in other age groups (χ2 = 27.661 , P = 0.000). The incidence of children with fracture in rural areas was 8.9%, significantly lower than that of urban children (χ2 = 30.283, P = 0.000). After multivariate non-conditional logistic regression analysis, OR = 2.005, 95% CI = 1.179-5.912), age (OR = 1.316, 95% CI = 1.011-2.529), indulgence (OR = 1.316, 95% CI = 1.088-2.915) , 95% CI = 1.004-1.980) were the main risk factors for the complication in children with fracture. The patients were protected by timely rehabilitation (OR = 0.511, 95% CI = 0.221-0.810). Conclusions The main complications of accidental fracture in children are ischemic muscle spasm and nerve palsy, over-cautiousness, age, family drowsiness and parental culture as the main risk factors. It is a protective factor to recover in time.