本文選題：骨質(zhì)疏松 + 髖部骨折　； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]回顧性分析髖部脆性骨折患者的部分流行病學(xué)分布特征。[方法]收集1344例2013年在云南省昆明市10所醫(yī)院因髖部骨折住院患者信息,在所有髕部骨折的患者中脆性骨折例數(shù)為858例,占63.8%。收集髕部脆性骨折患者的基本信息,包括性別、年齡、骨折部位、治療方式、手術(shù)方式、住院時(shí)長間、住院費(fèi)用,基礎(chǔ)疾病情況、住院期間并發(fā)癥情況、骨折誘因等。[結(jié)果]①跌倒是導(dǎo)致髖部脆性骨折最常見的誘因,占92.6%。②有效隨訪患者430例,男性149例,占34.7%,女性281例,占65.3%,女性與男性總體比例1.88:1,女性明顯多于男性,差異有統(tǒng)計(jì)學(xué)意義(P0.05);70～89歲之間骨折人數(shù)最多,占81.63%;股骨粗隆間骨折明顯多于股骨頸骨折,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。年齡、性別與骨折部位無明顯相關(guān)性(P0.05)。③手術(shù)方式、基礎(chǔ)疾病情況、就診醫(yī)院等級(jí)對(duì)住院時(shí)間無影響(P0.05);手術(shù)治療及住院期間發(fā)生并發(fā)癥可能延長住院時(shí)間,P0.05,差異有統(tǒng)計(jì)學(xué)意義。④手術(shù)方式、基礎(chǔ)疾病情況與住院費(fèi)用無明顯相關(guān)性(P0.05);選擇手術(shù)治療、住院期間發(fā)生并發(fā)癥及在三甲醫(yī)院治療是住院費(fèi)用增加的可能原因,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]①70～89歲是髖部脆性骨折的好發(fā)年齡,女性多于男性,骨折部位以股骨粗隆間多見,預(yù)防跌倒是預(yù)防髖部脆性骨折的重要環(huán)節(jié)。②選擇手術(shù)治療及合并并發(fā)癥可能是導(dǎo)致住院時(shí)間延長及住院費(fèi)用增加的原因。[目的]了解髖部脆性骨折患者骨折3年后死亡情況、患肢疼痛情況及生活自理能力,并探討其可能的影響因素。[方法]電話隨訪所收集患者的死亡情況(死亡時(shí)間、死亡原因)、骨折后是否予骨質(zhì)疏松治療、骨折3年后患肢疼痛情況及生活自理能力,并進(jìn)行分析。[結(jié)果]①骨折后3年總死亡人數(shù)164人,骨折后半年死亡率為17.44%,骨折后1年死亡率為25.35%,骨折后2年死亡率為31.46%,骨折后3年死亡率為36.74%。導(dǎo)致死亡的直接原因有心腦血管事件、肺部感染、多器官功能衰竭及其他。年齡、治療方式的選擇、骨折部位、骨折后是否予骨質(zhì)疏松治療可能是死亡的主要影響因素。②年齡、基礎(chǔ)疾病及并發(fā)癥情況是骨折后3年是否存在患肢骨痛的影響因素,P0.05;年齡、是否有并發(fā)癥及是否予骨質(zhì)疏松治療是骨折后3年功能恢復(fù)情況的影響因素,P0.05。[結(jié)論]①髖部脆性骨折死亡率較高,應(yīng)重視髖部脆性骨折患者基礎(chǔ)疾病的治療。年齡、骨折部位、治療方式、骨折后是否予骨質(zhì)疏松治療可能是死亡的危險(xiǎn)因素。②年齡、基礎(chǔ)疾病情況、并發(fā)癥情況可能與髖部脆性骨折后患肢疼痛情況相關(guān)。年齡、并發(fā)癥情況及骨折后是否予骨松治療與骨折后生活自理能力相關(guān)。
[Abstract]:[Objective] to retrospective analyze the epidemiological distribution characteristics of the patients with hip brittle fracture. [Methods] 1344 cases of patients with hip fractures in 10 hospitals in Kunming, Yunnan Province, in 2013, were collected. The number of brittle fracture cases in all patients with patellar fracture was 858 cases, which accounted for the basic information of the patients with 63.8%. patellar brittle fractures. Sex, age, fracture site, mode of treatment, operation mode, length of hospitalization, hospitalization expenses, basic disease, complications during hospitalization, fracture inducement, etc. [results] falling is the most common cause of brittle fracture of the hip, which accounts for 430 cases of effective follow-up of 92.6%., 149 cases in males, 34.7%, 281 women, 65.3%, women and women. The overall proportion of men was 1.88:1, women were significantly more than men (P0.05); the number of fractures between 70~89 years of age was the most, accounting for 81.63%. The intertrochanteric fracture was significantly more than that of the femoral neck fracture. The difference was statistically significant (P0.05). There was no significant correlation between the age, sex and fracture location (P0.05). The hospital grade had no influence on the time of hospitalization (P0.05); the complications of surgical treatment and hospitalization may prolong the time of hospitalization and P0.05, the difference was statistically significant. (4) the operation mode, the condition of the basic disease and the hospitalization expenses had no significant correlation (P0.05); the choice of surgical treatment, the complications during the hospitalization and the treatment in the three a hospital The possible reasons for the increase of hospital costs were statistically significant (P0.05). [Conclusion] (Conclusion] 70~89 years old is the good onset age of brittle fracture of the hip, more women than men, the fracture site is more common in the intertrochanteric femoral intertrochanter, and the prevention of falls is an important link in the prevention of brittle fracture of the hip. [Objective] to understand the causes of death in patients with brittle fracture of the hip after 3 years of fracture, the condition of limb pain and self-care, and to explore the possible influencing factors. [Methods] the death of the patients (death time, cause of death) was collected by telephone follow-up, and the treatment of osteoporosis after the fracture, and 3 of the fracture. The total death rate of 3 years after fracture was 164, the death rate after fracture was 17.44%, the mortality rate of 1 year after fracture was 25.35%, the mortality rate of 2 years after fracture was 31.46%, and the death rate of 3 years after fracture was 36.74%., the direct cause of death was cardio cerebral vascular events, pulmonary infection. Multiple organ failure and other. Age, choice of treatment, fracture site, and the treatment of osteoporosis after the fracture may be the main factors of death. Age, basic disease and complications are the factors affecting bone pain in the 3 year after fracture, P0.05; age, complications and osteoporosis Treatment is the influencing factor of functional recovery of 3 years after fracture. P0.05.[conclusion: (1) the mortality of brittle fracture of the hip is high. The treatment of basic diseases of the brittle fracture of the hip should be paid attention to. Age, fracture site, treatment and the treatment of osteoporosis after the fracture may be the risk factors of death and death. The condition of the disease may be related to the pain of the limb after the brittle fracture of the hip. The age, the complication and the treatment of the bone loosening after the fracture are related to the ability to take care of the life after the fracture.

【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R683

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