遼寧省兩所三甲醫(yī)院老年骨質(zhì)疏松性骨折的發(fā)病特點(diǎn)及診療現(xiàn)狀
發(fā)布時(shí)間：2018-08-07 16:40
【摘要】：目的:通過(guò)對(duì)遼寧省沈陽(yáng)、大連某兩所三甲醫(yī)院老年骨質(zhì)疏松性骨折患者的臨床資料調(diào)查分析,了解兩地老年骨質(zhì)疏松性骨折的發(fā)病特點(diǎn)、診斷、治療以及二級(jí)預(yù)防現(xiàn)狀,為該地區(qū)進(jìn)一步做好老年骨質(zhì)疏松性骨折的診治和預(yù)防工作提供依據(jù)。方法:分別收集整理2015年1月至2015年12月大連市某三甲醫(yī)院406例和沈陽(yáng)市某三甲醫(yī)院365例60歲以上老年骨質(zhì)疏松性骨折住院患者的臨床資料,對(duì)其基本情況(年齡、性別、舒張壓、收縮壓、體重、身高、BMI)、臨床資料(血清堿性磷酸酶、血清白蛋白、血肌酐、內(nèi)生肌酐清除率、空腹血糖、血清鈣、血磷、合并癥、骨折部位、骨折次數(shù)、骨折季節(jié)、影像學(xué)檢查、是否手術(shù))、診斷及抗骨質(zhì)疏松治療情況進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.大連某醫(yī)院60歲以上老年骨質(zhì)疏松性骨折人數(shù)占骨折總?cè)藬?shù)的37.52%(406/1082例),其中女性291例,平均年齡(73.84±8.85)歲,白蛋白平均值(39.49±4.99)g/L,空腹血糖平均值(5.96±2.61)mmol/L;男性115例,平均年齡(74.92±9.79)歲,白蛋白平均值(38.90±4.92)g/L,空腹血糖平均值(6.02±1.75)mmol/L。沈陽(yáng)某醫(yī)院60歲以上老年骨質(zhì)疏松性骨折人數(shù)占骨折總?cè)藬?shù)的47.10%(365/775例),其中女性252例,平均年齡(74.50±8.43)歲,白蛋白平均值(39.37±4.17)g/L,空腹血糖平均值(5.98±1.75)mmol/L;男性113例,平均年齡(71.65±8.20)歲,白蛋白平均值(38.06±3.99)g/L,空腹血糖平均值(5.85±1.49)mmol/L。兩所醫(yī)院老年骨質(zhì)疏松性骨折占骨折總?cè)藬?shù)的比率均較高,且女性多于男性�；颊哐灏椎鞍灼毡檩^正常值偏低,空腹血糖為正常值高限。2.兩所醫(yī)院老年骨質(zhì)疏松性骨折患者的常見(jiàn)合并癥均為高血壓、腔隙性腦梗塞、冠心病、糖尿病。大連某醫(yī)院研究對(duì)象合并2種疾病者96例(23.65%),合并3種及以上疾病者82例(20.20%)。沈陽(yáng)某醫(yī)院研究對(duì)象合并2種疾病者99例(27.12%),合并3種及以上疾病者67例(18.36%)。兩所醫(yī)院老年骨質(zhì)疏松性骨折患者多病共存現(xiàn)象較為普遍。3.兩所醫(yī)院老年骨質(zhì)疏松性骨折的好發(fā)部位均依次為髖部、脊柱、尺橈骨遠(yuǎn)端、肱骨近端。大連某醫(yī)院研究對(duì)象中單部位骨折327例(80.54%),多部位骨折79例(19.46%),發(fā)生再次骨折54例(13.30%)。沈陽(yáng)某醫(yī)院研究對(duì)象中單部位骨折310例(84.93%),多部位骨折55例(15.07%),發(fā)生再次骨折30例(8.22%)。4.大連某醫(yī)院老年骨質(zhì)疏松性骨折有52.96%發(fā)生在冬春季,47.04%發(fā)生在夏秋季。沈陽(yáng)某醫(yī)院老年骨質(zhì)疏松性骨折有51.23%發(fā)生在冬春季,48.77%發(fā)生在夏秋季。兩所醫(yī)院老年骨質(zhì)疏松性骨折患者的發(fā)病季節(jié)均為冬春季多于夏秋季。5.大連某醫(yī)院老年骨質(zhì)疏松性骨折患者中給予骨質(zhì)疏松癥診斷的有50例(12.32%),在院期間給予骨質(zhì)疏松治療的有91例(22.41%),其中抗骨質(zhì)疏松治療用藥種類為1種者54例(13.30%)、2種27例(6.65%)、3種10例(2.46%);出院醫(yī)囑中給予骨質(zhì)疏松治療的有83例(20.45%),其中抗骨質(zhì)疏松治療用藥種類為1種者57例(14.04%)、2種20例(4.93%)、3種6例(1.48%);有3例(0.74%)脆性骨折患者既診斷了骨質(zhì)疏松癥又在住院期間和出院醫(yī)囑中均給予骨質(zhì)疏松規(guī)范治療。沈陽(yáng)某醫(yī)院老年骨質(zhì)疏松性骨折患者中給予骨質(zhì)疏松癥診斷的有57例(15.62%),在院期間給予骨質(zhì)疏松治療的有99例(27.12%),其中抗骨質(zhì)疏松治療用藥種類為1種者60例(16.44%)、2種32例(8.76%)、3種7例(1.92%);出院醫(yī)囑中給予骨質(zhì)疏松治療的有62例(16.98%),其中抗骨質(zhì)疏松治療用藥種類為1種者46例(12.60%)、2種12例(3.29%)、3種4例(1.09%);有2例(0.55%)脆性骨折患者既診斷了骨質(zhì)疏松癥又在住院期間和出院醫(yī)囑中均給予骨質(zhì)疏松規(guī)范治療。兩所醫(yī)院骨質(zhì)疏松癥的診斷率、規(guī)范化治療率及聯(lián)合用藥率均較低。結(jié)論:1.遼寧該地區(qū)老年骨質(zhì)疏松性骨折的患者發(fā)病有其地區(qū)特點(diǎn),尤其在患病人數(shù)、性別、血清白蛋白、空腹血糖、骨折部位、骨折次數(shù)、骨折季節(jié)、合并癥有一定分布規(guī)律。2.目前該地區(qū)老年骨質(zhì)疏松癥的重視程度仍然不夠,骨質(zhì)疏松癥的診斷、治療及二級(jí)預(yù)防現(xiàn)狀不容樂(lè)觀,應(yīng)加強(qiáng)宣傳并提高診療水平,采取防治策略以減緩老年骨質(zhì)疏松癥的進(jìn)展和預(yù)防脆性骨折的發(fā)生。
[Abstract]:Objective: to understand the characteristics, diagnosis, treatment and the status of two grade prevention of osteoporotic fracture in the elderly of two hospitals in Shenyang and Dalian, Liaoning, and to provide the prevention and treatment and prevention of osteoporotic fracture in the area. Methods: to collect and collate the clinical data of 406 hospitalized patients with osteoporotic fractures over 60 years old in a three a hospital in Dalian from January 2015 to December 2015, and 365 cases of elderly osteoporotic fractures in a three a hospital in Shenyang. The basic conditions (age, sex, diastolic pressure, systolic pressure, weight, height, BMI), clinical data (serum alkaline phosphatase, blood) Albumin, blood creatinine, endogenous creatinine clearance, fasting blood glucose, serum calcium, blood phosphorus, complication, fracture site, fracture times, fracture season, imaging examination, or not surgery), diagnosis and treatment of anti osteoporosis. Results: 1. the number of osteoporotic fractures over 60 years old in a hospital in Dalian accounted for 3 of the total number of fractures. 7.52% (406/1082 cases), of which 291 were female, average age (73.84 + 8.85), albumin average (39.49 + 4.99) g/L, average value of fasting blood glucose (5.96 + 2.61) mmol/L, male 115, average age (74.92 + 9.79) years, average value of albumin (38.90 + 4.92) g/ L, and average value of fasting blood glucose (mmol/L.) in a certain hospital in Shenyang The number of osteoporotic fractures accounted for 47.10% of the total number of fractures (365/775 cases), of which 252 cases were female, average age (74.50 + 8.43) years, albumin average (39.37 + 4.17) g/L, average value of fasting blood glucose (5.98 + 1.75) mmol/L, male 113 cases, average age (71.65 + 8.20) years, albumin average (38.06 + 3.99) g/L, average value of fasting blood glucose (mmol/) mmol/ L. two hospital aged osteoporotic fractures accounted for a higher proportion of the total number of fractures, and women were more than men. The serum albumin was generally lower than the normal value. The common complications of osteoporotic fracture patients in the elderly.2. two hospital were high blood pressure, lacunar cerebral infarction, coronary heart disease and diabetes. In a hospital in Dalian, 96 cases (23.65%) were combined with 2 diseases, 82 cases (20.20%) were combined with 3 or more diseases. 99 cases (27.12%) were combined with 2 diseases in a hospital in Shenyang, 3 or 67 (18.36%) were combined with 3 or more diseases. The coexistence of multiple diseases in elderly osteoporotic fractures in the hospital was more common in.3. hospitals. There were 327 cases of single part fracture in Dalian hospital (80.54%), 79 cases of multiple fractures (19.46%), 54 cases of fracture (13.30%), and 310 cases (84.93%) of single site fracture in a hospital in Shenyang, 55 cases of multiple site fractures (15. 07%), there were 30 cases of fracture again (8.22%) in.4. Dalian, 52.96% of the elderly osteoporotic fractures occurred in winter and spring, 47.04% occurred in summer and autumn. 51.23% of old osteoporotic fractures occurred in winter and spring in a hospital in Shenyang, 48.77% occurred in summer and autumn. Two hospital old osteoporotic fractures were in winter. There were 50 cases (12.32%) in the diagnosis of osteoporosis in the elderly patients with osteoporotic fracture in.5. Dalian hospital in spring more than in summer and autumn. 91 cases (22.41%) were given osteoporosis treatment during the hospital, of which 54 cases (13.30%), 2 27 cases (6.65%) and 3 10 (2.46%) were treated with anti osteoporosis treatment, and the medical orders were given to bone. There were 83 cases of osteoporosis treatment (20.45%), of which 1 kinds of anti osteoporosis treatment were 1 species (14.04%), 2 20 cases (4.93%), 3 6 cases (1.48%), and 3 (0.74%) brittle fracture patients both diagnosed osteoporosis and given osteoporosis standard treatment during hospitalization and discharge medical advice. The elderly osteoporotic bone in a hospital in Shenyang There were 57 cases (15.62%) in the diagnosis of osteoporosis and 99 cases (27.12%) for osteoporosis treatment during the hospital, of which 60 cases (16.44%), 2 32 cases (8.76%) and 3 7 cases (1.92%) were treated with anti osteoporosis treatment, and the treatment of osteoporosis was given in 99 cases (8.76%). There were 1 species (12.60%), 2 12 cases (3.29%), 3 4 cases (1.09%); 2 cases (0.55%) fragile fracture patients both diagnosed osteoporosis and given osteoporosis during hospitalization and discharged medical orders. The diagnosis rate of osteoporosis, standardized treatment rate and combination rate were low in two hospital. Conclusion: 1. Liaoning Patients with osteoporotic fractures in the area have their regional characteristics, especially in the number of diseases, sex, serum albumin, fasting blood sugar, fracture site, fracture times, fracture season, and the regularity of complication,.2. is still not paid enough attention to the elderly osteoporosis in this area, diagnosis, treatment and treatment of osteoporosis. The status of the two level prevention is not optimistic. We should strengthen the publicity and improve the level of diagnosis and treatment, take prevention and cure strategies to slow down the progress of senile osteoporosis and prevent the occurrence of brittle fracture.
【學(xué)位授予單位】：大連醫(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)】：R580;R683
本文編號(hào)：2170678
[Abstract]:Objective: to understand the characteristics, diagnosis, treatment and the status of two grade prevention of osteoporotic fracture in the elderly of two hospitals in Shenyang and Dalian, Liaoning, and to provide the prevention and treatment and prevention of osteoporotic fracture in the area. Methods: to collect and collate the clinical data of 406 hospitalized patients with osteoporotic fractures over 60 years old in a three a hospital in Dalian from January 2015 to December 2015, and 365 cases of elderly osteoporotic fractures in a three a hospital in Shenyang. The basic conditions (age, sex, diastolic pressure, systolic pressure, weight, height, BMI), clinical data (serum alkaline phosphatase, blood) Albumin, blood creatinine, endogenous creatinine clearance, fasting blood glucose, serum calcium, blood phosphorus, complication, fracture site, fracture times, fracture season, imaging examination, or not surgery), diagnosis and treatment of anti osteoporosis. Results: 1. the number of osteoporotic fractures over 60 years old in a hospital in Dalian accounted for 3 of the total number of fractures. 7.52% (406/1082 cases), of which 291 were female, average age (73.84 + 8.85), albumin average (39.49 + 4.99) g/L, average value of fasting blood glucose (5.96 + 2.61) mmol/L, male 115, average age (74.92 + 9.79) years, average value of albumin (38.90 + 4.92) g/ L, and average value of fasting blood glucose (mmol/L.) in a certain hospital in Shenyang The number of osteoporotic fractures accounted for 47.10% of the total number of fractures (365/775 cases), of which 252 cases were female, average age (74.50 + 8.43) years, albumin average (39.37 + 4.17) g/L, average value of fasting blood glucose (5.98 + 1.75) mmol/L, male 113 cases, average age (71.65 + 8.20) years, albumin average (38.06 + 3.99) g/L, average value of fasting blood glucose (mmol/) mmol/ L. two hospital aged osteoporotic fractures accounted for a higher proportion of the total number of fractures, and women were more than men. The serum albumin was generally lower than the normal value. The common complications of osteoporotic fracture patients in the elderly.2. two hospital were high blood pressure, lacunar cerebral infarction, coronary heart disease and diabetes. In a hospital in Dalian, 96 cases (23.65%) were combined with 2 diseases, 82 cases (20.20%) were combined with 3 or more diseases. 99 cases (27.12%) were combined with 2 diseases in a hospital in Shenyang, 3 or 67 (18.36%) were combined with 3 or more diseases. The coexistence of multiple diseases in elderly osteoporotic fractures in the hospital was more common in.3. hospitals. There were 327 cases of single part fracture in Dalian hospital (80.54%), 79 cases of multiple fractures (19.46%), 54 cases of fracture (13.30%), and 310 cases (84.93%) of single site fracture in a hospital in Shenyang, 55 cases of multiple site fractures (15. 07%), there were 30 cases of fracture again (8.22%) in.4. Dalian, 52.96% of the elderly osteoporotic fractures occurred in winter and spring, 47.04% occurred in summer and autumn. 51.23% of old osteoporotic fractures occurred in winter and spring in a hospital in Shenyang, 48.77% occurred in summer and autumn. Two hospital old osteoporotic fractures were in winter. There were 50 cases (12.32%) in the diagnosis of osteoporosis in the elderly patients with osteoporotic fracture in.5. Dalian hospital in spring more than in summer and autumn. 91 cases (22.41%) were given osteoporosis treatment during the hospital, of which 54 cases (13.30%), 2 27 cases (6.65%) and 3 10 (2.46%) were treated with anti osteoporosis treatment, and the medical orders were given to bone. There were 83 cases of osteoporosis treatment (20.45%), of which 1 kinds of anti osteoporosis treatment were 1 species (14.04%), 2 20 cases (4.93%), 3 6 cases (1.48%), and 3 (0.74%) brittle fracture patients both diagnosed osteoporosis and given osteoporosis standard treatment during hospitalization and discharge medical advice. The elderly osteoporotic bone in a hospital in Shenyang There were 57 cases (15.62%) in the diagnosis of osteoporosis and 99 cases (27.12%) for osteoporosis treatment during the hospital, of which 60 cases (16.44%), 2 32 cases (8.76%) and 3 7 cases (1.92%) were treated with anti osteoporosis treatment, and the treatment of osteoporosis was given in 99 cases (8.76%). There were 1 species (12.60%), 2 12 cases (3.29%), 3 4 cases (1.09%); 2 cases (0.55%) fragile fracture patients both diagnosed osteoporosis and given osteoporosis during hospitalization and discharged medical orders. The diagnosis rate of osteoporosis, standardized treatment rate and combination rate were low in two hospital. Conclusion: 1. Liaoning Patients with osteoporotic fractures in the area have their regional characteristics, especially in the number of diseases, sex, serum albumin, fasting blood sugar, fracture site, fracture times, fracture season, and the regularity of complication,.2. is still not paid enough attention to the elderly osteoporosis in this area, diagnosis, treatment and treatment of osteoporosis. The status of the two level prevention is not optimistic. We should strengthen the publicity and improve the level of diagnosis and treatment, take prevention and cure strategies to slow down the progress of senile osteoporosis and prevent the occurrence of brittle fracture.
【學(xué)位授予單位】：大連醫(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)】：R580;R683
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