背景:关节置换是治疗老年移位性股骨颈骨折的主要手段,全髋关节置换与半髋关节置换的选择是目前具有较大争论的焦点。目的:基于倾向性评分匹配法对比直接前入路下全髋与半髋关节置换治疗老年移位性股骨颈骨折的中远期生存状态。方法:选...背景:关节置换是治疗老年移位性股骨颈骨折的主要手段,全髋关节置换与半髋关节置换的选择是目前具有较大争论的焦点。目的:基于倾向性评分匹配法对比直接前入路下全髋与半髋关节置换治疗老年移位性股骨颈骨折的中远期生存状态。方法:选择2016年1月至2021年1月收治的147例老年移位性股骨颈骨折患者(≥65岁),其中88例行全髋关节置换,59例行人工股骨头置换(半髋关节置换)。对于患者术前合并症采用年龄校正Charlson合并症评分表,计算患者虚弱度,并采用倾向性评分匹配法对两组患者进行1∶1匹配,比较匹配后两组患者的手术时间、出血量、术后住院时间、住院费用、营养指标、术后并发症、死亡率和术后生存时间,其中术后生存时间采用Kaplan-Meier生存分析。结果与结论:①倾向性评分匹配后,两组共有42对匹配成功,匹配后两组患者术前资料均衡可比(P>0.05);②与半髋关节置换组相比,全髋关节置换组手术时间(79.71 min vs.59.07 min,P<0.001)、出血量(839.64 mL vs.597.83 mL,P=0.001)、住院费用(56508.15元vs.41702.85元,P<0.001)明显增加,但全髋关节置换组死亡率低于半髋关节置换组(36%vs.57%,HR=0.44,95%CI:0.23-0.87,P=0.018),平均生存时间长于半髋关节置换组(59.4个月vs.43.7个月,P=0.024);③两组患者在术后住院时间、术前术后营养指标、术后整体并发症发生率上,差异均无显著性意义(P>0.05);但在术后疼痛方面,半髋关节置换组疼痛发生率明显高于全髋关节置换组(24%vs.7%,P=0.035);④整体来看,全髋关节置换具有更好的长期预后生存效果,但对于身体素质差的患者则更适合行半髋关节置换;同时,术后的疼痛可能很大程度上会对患者髋关节置换后的生活质量及存活时间产生影响。展开更多
Using disordered multinomial logistic regression and multiple linear regression method,385 copies of questionnaires on farmer are analyzed to explore the relationship between peasant's psychological traits,peasant...Using disordered multinomial logistic regression and multiple linear regression method,385 copies of questionnaires on farmer are analyzed to explore the relationship between peasant's psychological traits,peasant's cognition on seed technology and perception on supplydemand matching of new variety.Research results show that the vast majority of farmers think that current new variety is at high-level supplydemand balance and the oversupply status,and updating speed of new variety on the market is faster;the farmers preferring risk,seeking innovation and having strong learning and cognition ability may select high-level supply-demand matching state,and the farmers understanding the importance and difference of seed technology tend to choose high-level supply-demand matching situation;the farmers with strong learning and cognition ability can acknowledge the importance and difference of seed technology,while the farmers preferring risk can perceive the difference of seed technology;psychology seeking the innovation and learning and cognition ability affect the farmer's perception on supplydemand matching status of new variety via affecting the farmer's cognition on technical difference.展开更多
文摘背景:关节置换是治疗老年移位性股骨颈骨折的主要手段,全髋关节置换与半髋关节置换的选择是目前具有较大争论的焦点。目的:基于倾向性评分匹配法对比直接前入路下全髋与半髋关节置换治疗老年移位性股骨颈骨折的中远期生存状态。方法:选择2016年1月至2021年1月收治的147例老年移位性股骨颈骨折患者(≥65岁),其中88例行全髋关节置换,59例行人工股骨头置换(半髋关节置换)。对于患者术前合并症采用年龄校正Charlson合并症评分表,计算患者虚弱度,并采用倾向性评分匹配法对两组患者进行1∶1匹配,比较匹配后两组患者的手术时间、出血量、术后住院时间、住院费用、营养指标、术后并发症、死亡率和术后生存时间,其中术后生存时间采用Kaplan-Meier生存分析。结果与结论:①倾向性评分匹配后,两组共有42对匹配成功,匹配后两组患者术前资料均衡可比(P>0.05);②与半髋关节置换组相比,全髋关节置换组手术时间(79.71 min vs.59.07 min,P<0.001)、出血量(839.64 mL vs.597.83 mL,P=0.001)、住院费用(56508.15元vs.41702.85元,P<0.001)明显增加,但全髋关节置换组死亡率低于半髋关节置换组(36%vs.57%,HR=0.44,95%CI:0.23-0.87,P=0.018),平均生存时间长于半髋关节置换组(59.4个月vs.43.7个月,P=0.024);③两组患者在术后住院时间、术前术后营养指标、术后整体并发症发生率上,差异均无显著性意义(P>0.05);但在术后疼痛方面,半髋关节置换组疼痛发生率明显高于全髋关节置换组(24%vs.7%,P=0.035);④整体来看,全髋关节置换具有更好的长期预后生存效果,但对于身体素质差的患者则更适合行半髋关节置换;同时,术后的疼痛可能很大程度上会对患者髋关节置换后的生活质量及存活时间产生影响。
文摘Using disordered multinomial logistic regression and multiple linear regression method,385 copies of questionnaires on farmer are analyzed to explore the relationship between peasant's psychological traits,peasant's cognition on seed technology and perception on supplydemand matching of new variety.Research results show that the vast majority of farmers think that current new variety is at high-level supplydemand balance and the oversupply status,and updating speed of new variety on the market is faster;the farmers preferring risk,seeking innovation and having strong learning and cognition ability may select high-level supply-demand matching state,and the farmers understanding the importance and difference of seed technology tend to choose high-level supply-demand matching situation;the farmers with strong learning and cognition ability can acknowledge the importance and difference of seed technology,while the farmers preferring risk can perceive the difference of seed technology;psychology seeking the innovation and learning and cognition ability affect the farmer's perception on supplydemand matching status of new variety via affecting the farmer's cognition on technical difference.
