国际老年医学杂志2024，Vol.45Issue(4)：454-458,5.DOI:10.3969/j.issn.1674-7593.2024.04.013
CT评估胸大肌参数对老年肋骨骨折术后肺部并发症的预测
CT Evaluation of Pectoralis Major Muscle Parameters in Predicting Postoperative Pulmonary Complications in Elderly Patients with Rib Fracture
摘要
Abstract
Objective To investigate the predictive value of CT evaluation of pectoralis major muscle parameters for pul-monary complications after rib fracture surgery in the elderly.Methods A total of 105 elderly patients who underwent surgical treat-ment for rib fracture at Tianjin Hospital in Tianjin,China,from January 2021 to October 2023 were selected.Postoperatively,pa-tients were divided into a complication group(28 cases)and a non-complication group(77 cases)based on whether pulmonary complications occurred.Upon admission,general information such as gender,age,height,smoking history,presence of underlying respiratory diseases,and disease course were recorded for both groups.The pectoralis major index and density(PMI,PMD)were measured using CT scans.Multivariate logistic regression analysis was used to investigate the predictive value of general patient infor-mation and pectoralis major muscle parameters for postoperative pulmonary complications in elderly patients with rib fracture.Results Postoperative pulmonary complications occurred in 28 patients(26.7%).Univariate logistic regression model analysis showed that age≥70 years,smoking history,history of underlying pulmonary diseases,disease duration≥72 hours,and rib fractures≥5 could lead to postoperative pulmonary complications in elderly patients with rib fractures(P<0.05);multivariate logistic regression analysis showed that age≥70 years,smoking history,history of underlying pulmonary diseases,disease duration≥72 hours,and number of rib fractures≥5,bilateral rib fractures and PMI and PMD were all independent risk factors leading to postoperative pul-monary complications in elderly patients with rib fractures(P<0.05).The results of ROC curve analysis showed that the area un-der the curve of PMD in predicting pulmonary complications after rib fracture surgery was 0.832(95%CI:0.746-0.918),and the area under the curve of PMI in predicting pulmonary complications after rib fracture surgery was 0.732(95%CI:0.773-0.937),both of which had a good predictive effect on whether pulmonary complications occurred after rib fracture surgery in pa-tients.Conclusion Assessing pectoralis major muscle parameters by CT is an effective tool to predict whether patients develop pul-monary complications after surgery,and timely adjustment of patients'treatment options according to patients'prediction results is of great significance in improving patients'prognosis.关键词
肋骨骨折/肺部并发症/胸大肌指数/胸大肌密度Key words
Rib fracture/Pulmonary complication/Pectoralis major index/Pectoralis major density引用本文复制引用
宫颢,夏洪刚,朱鹏志,孙忠义,张永民,张海泉,王冬滨..CT评估胸大肌参数对老年肋骨骨折术后肺部并发症的预测[J].国际老年医学杂志,2024,45(4):454-458,5.基金项目
天津市科技计划项目(20JCZDJC00580) （20JCZDJC00580）
天津市卫生健康科技项目(ZD20012) （ZD20012）
