| 股骨颈骨折术后早期股骨头坏死影响因素分析及列线图预测模型构建 |
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投稿时间：2023-07-01 修订日期：2023-12-16
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
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| 基金项目:衢州市科学技术局指导性科技攻关项目(编号：2021026) |
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| 中文摘要:目的：探讨股骨颈骨折患者术后早期发生股骨头坏死的危险因素,并建立列线图预测模型。方法：选取2020年1月至2022年4月衢州市人民医院167例行固定手术治疗的股骨颈骨折患者,根据患者术后早期是否发生股骨头坏死分为坏死组和非坏死组,对可能相关的因素进行Logistic回归分析,并构建列线图风险模型。结果：167例股骨颈骨折患者术后股骨头坏死的发生率为22.76%。合并糖尿病、骨折移位情况、术前制动牵引、复位质量和受伤至手术时间是股骨颈骨折患者术后早期发生股骨头坏死的独立危险因素(OR＞1,P＜0.05)。Hosmer-Lemeshow拟合优度检验χ2=3.951,P=0.862,ROC曲线下面积为0.944(P<0.001,95%CI：0.903-0.987),灵敏度为89.50%,特异性为88.40%,最大约登指数为0.779,模型校正曲线总体趋势接近理想曲线。模型回归方程Z=1.637×合并糖尿病+1.314×骨折移位情况+1.237×术前制动牵引+1.260×复位质量+0.239×受伤至手术时间-18.310。结论：股骨颈骨折患者术后早期股骨头坏死的发生受多重因素共同影响,根据因素建立的风险预警模型具有较好的预测效能,适合临床推广。 |
| 【关键词】股骨颈骨折 固定手术 股骨头坏死 列线图预测模型 |
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| Analysis of influencing factors of early femoral head necrosis after femoral neck fracture and construction of nomogram prediction model |
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| ABSTRACT Objective: To explore the risk factors of early femoral head necrosis in patients with femoral neck fracture after operation, and to establish a nomogram prediction model.Methods: A total of 167 patients with femoral neck fracture who underwent fixed surgery in Quzhou People "s Hospital from January 2020 to April 2022 were selected and divided into necrosis group and non-necrosis group according to whether femoral head necrosis occurred in the early postoperative period. Logistic regression analysis was performed on possible related factors, and a nomogram risk model was constructed.Results: The incidence of femoral head necrosis in 167 patients with femoral neck fracture was 22.76%. Diabetes mellitus, fracture displacement, preoperative braking traction, reduction quality and time from injury to operation were independent risk factors for early postoperative femoral head necrosis in patients with femoral neck fracture ( OR > 1, P < 0.05 ). The Hosmer-Lemeshow goodness-of-fit test χ2 = 3.951, P = 0.862, the area under the ROC curve was 0.944 ( P < 0.001,95% CI : 0.903-0.9874 ), the sensitivity was 89.50%, the specificity was 88.40%, the maximum Youden index was 0.779, and the overall trend of the model correction curve was close to the ideal curve. Model regression equation Z = 1.637 × diabetes + 1.314 × fracture displacement + 1.237 × preoperative braking traction + 1.260 × reduction quality + 0.239 × injury to operation time ? 18.310.Conclusions: The occurrence of early femoral head necrosis in patients with femoral neck fracture after operation is affected by multiple factors. The risk early warning model established according to the factors has good predictive efficacy and is suitable for clinical promotion. |
| KEY WORDS femoral neck fracture fixed surgery femoral head necrosis nomogram prediction model |
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