本文選題：髖骨折 + 再骨折　； 參考：《中國(guó)骨傷》2016年04期

【摘要】：目的 :探討老年髖部發(fā)生二次骨折的相關(guān)風(fēng)險(xiǎn)因素,為預(yù)防對(duì)側(cè)髖部再骨折提供臨床依據(jù)。方法 :回顧性分析2008年12月至2014年2月378例老年髖部初次骨折患者的資料,男175例,女203例;年齡60~90歲,平均(75.53±8.04)歲;股骨頸骨折125例,股骨粗隆間骨折253例。術(shù)后隨訪12~36個(gè)月,平均24.9個(gè)月,32例患者發(fā)生對(duì)側(cè)髖部再骨折,男13例,女19例;年齡72~95歲,平均(81.25±5.94)歲;股骨頸骨折7例,股骨粗隆間骨折25例。根據(jù)患者術(shù)后有無(wú)對(duì)側(cè)髖部再骨折分為骨折組和無(wú)骨折組,比較兩組患者的年齡、性別、初次骨折類型、內(nèi)固定方式、臥床時(shí)間、骨質(zhì)疏松情況、合并內(nèi)科疾病情況、術(shù)后功能鍛煉、治療的依從性、生活環(huán)境(農(nóng)村/城市)和末次隨訪時(shí)Harris評(píng)分,對(duì)于P0.05的因素進(jìn)行多因素Logistic回歸性分析。結(jié)果:骨折組與無(wú)骨折組的年齡、骨質(zhì)疏松情況、合并內(nèi)科疾病情況、術(shù)后功能鍛煉、醫(yī)療依從性及末次隨訪時(shí)Harris評(píng)分比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素Logistic分析結(jié)果顯示:骨質(zhì)疏松(OR=6.793,P=0.001),高齡(OR=4.170,P=0.002),合并內(nèi)科疾病(OR=3.828,P=0.005),術(shù)后功能鍛煉(OR=0.297,P=0.005)以及醫(yī)療依從性(OR=0.295,P=0.007)是老年髖部骨折術(shù)后對(duì)側(cè)髖部再骨折的主要危險(xiǎn)因素。結(jié)論:老年髖部骨折術(shù)后對(duì)側(cè)再骨折主要危險(xiǎn)因素是高齡、骨質(zhì)疏松、合并內(nèi)科疾病、術(shù)后功能鍛煉和醫(yī)療依從性。術(shù)后需加強(qiáng)抗骨質(zhì)疏松治療、積極治療內(nèi)科疾病,堅(jiān)持功能鍛煉,以預(yù)防髖部再次骨折的發(fā)生。
[Abstract]:Objective: to investigate the risk factors of secondary hip fracture in elderly patients and to provide clinical evidence for prevention of contralateral hip refracture. Methods: the data of 378 elderly patients with primary hip fracture from December 2008 to February 2014 were retrospectively analyzed, including 175 males and 203 females, aged 60 to 90 years (mean 75.53 鹵8.04), femoral neck fracture in 125 cases and intertrochanteric fracture in 253 cases. Postoperative follow-up ranged from 12 to 36 months (mean 24.9 months) in 32 patients with refracture of the contralateral hip, including 13 males and 19 females, aged from 72 to 95 years (mean 81.25 鹵5.94) years, femoral neck fracture in 7 cases and intertrochanteric fracture in 25 cases. According to whether the patients had a contralateral hip refracture after operation, they were divided into two groups: fracture group and non-fracture group. The age, sex, type of primary fracture, internal fixation, bed rest time, osteoporosis, and internal medical diseases were compared between the two groups. Postoperative functional exercise, therapeutic compliance, living environment (rural / urban) and Harris score at the last follow-up were analyzed by multivariate Logistic regression analysis. Results: there were significant differences in age, osteoporosis, internal diseases, postoperative functional exercise, medical compliance and Harris score between the fracture group and the non-fracture group (P 0.05). The results of multivariate Logistic analysis showed that the main risk factors for the contralateral hip refracture in the elderly patients were: Osteoporosis (Osteoporosis) 6.793 (P0. 001), aged OR4. 170 (P0. 002), combined with internal diseases (OR3. 828) P0. 005, postoperative functional exercise (0. 297P0. 005) and medical compliance (OR0. 295P0. 007). Conclusion: the main risk factors of contralateral refracture after hip fracture in elderly patients are old age, osteoporosis, internal diseases, postoperative functional exercise and medical compliance. After operation, anti-osteoporosis treatment should be strengthened, internal diseases should be actively treated, and functional exercise should be carried out to prevent the occurrence of hip refracture.
【作者單位】： 寧波市北侖區(qū)人民醫(yī)院;
【分類號(hào)】：R687.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 夏玉萍;;骨質(zhì)疏松患者初次骨折后發(fā)生再骨折的風(fēng)險(xiǎn)及其臨床特點(diǎn)[J];亞太傳統(tǒng)醫(yī)藥;2012年12期

2 王錦繡,金玉星;股骨干骨折鋼板內(nèi)固定后再骨折的探討及對(duì)策[J];中原醫(yī)刊;2000年07期

3 岳德波,李子榮;福善美預(yù)防絕經(jīng)后胸腰椎壓縮性骨折再骨折25例療效觀察[J];中國(guó)骨質(zhì)疏松雜志;2003年04期

4 廖鴻,陳德龍,蒲仁堯,向道友,陳小龍;股骨干骨折內(nèi)固定術(shù)后再骨折原因及治療[J];職業(yè)衛(wèi)生與病傷;2005年01期

5 鐘明亮;;下肢骨痂延長(zhǎng)術(shù)后并發(fā)再骨折的危險(xiǎn)因素分析[J];中外醫(yī)療;2012年23期

6 李援立;陳凱;武占紅;李成軍;;股骨鋼板取出后再骨折臨床分析[J];當(dāng)代醫(yī)學(xué);2011年08期

7 楊玉安;;絕經(jīng)后婦女骨折后再骨折的危險(xiǎn)因素分析[J];生物技術(shù)世界;2014年04期

8 杜文藝;;絕經(jīng)后婦女骨折后再骨折的危險(xiǎn)因素分析[J];中國(guó)老年學(xué)雜志;2013年03期

9 張永貴;;骨質(zhì)疏松骨折后再骨折的臨床風(fēng)險(xiǎn)因素[J];大家健康(學(xué)術(shù)版);2014年02期

10 彭晉升;鄒德威;周建偉;;骨質(zhì)疏松性椎體壓縮骨折骨水泥強(qiáng)化術(shù)后再骨折研究進(jìn)展[J];解放軍醫(yī)學(xué)院學(xué)報(bào);2013年05期

相關(guān)會(huì)議論文 前6條

1 周文雄;鄭忠東;;骨折術(shù)后再骨折[A];第五屆中國(guó)中西醫(yī)結(jié)合圍手術(shù)期醫(yī)學(xué)研討會(huì)論文集[C];2010年

2 顏孫芳;武少坤;廖維;崔偉;呂揚(yáng)訓(xùn);楊雷;;老年骨質(zhì)疏松性髖部骨折術(shù)后再骨折風(fēng)險(xiǎn)的對(duì)照研究[A];2012年浙江省骨質(zhì)疏松與骨礦鹽疾病學(xué)術(shù)年會(huì)暨《骨質(zhì)疏松癥診治進(jìn)展》專題研討班論文集[C];2012年

3 端木群力;黃東輝;趙琦輝;劉新功;朱紅;武W毶，

本文編號(hào)：1892779