2003年至2012年河北医科大学第三医院成人胫骨平台骨折的流行病学分析

发布时间：2018-03-05 07:54

本文选题：胫骨平台骨折　切入点：成人　出处：《河北医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:胫骨平台骨折属胫骨近端的关节内骨折,是下肢常见骨折之一,多由高能量损伤引起,可伴有不同程度的关节面压缩与移位,将影响膝关节的对合、稳定性与运动。目前国内对于成人胫骨平台骨折发病特点和趋势的研究较少,因此我们调查我院2003~2012年10年间成人胫骨平台骨折病历资料,并对前后5年资料进行对比,旨在更加全面地了解成人胫骨平台骨折的流行病学特征,并分析其发展趋势。方法:利用医学影像计算机存档与传输系统(PACS)及病案查询系统调阅河北医科大学第三医院2003年1月至2012年12月诊治的全部成人骨折资料。纳入标准:新鲜骨折、年龄≥16周岁。排除标准:颅骨、下颌骨、肋骨、胸骨骨折,病理性骨折,假体周围骨折,陈旧骨折。将筛选出的全部骨折X线片按AO骨折分类原则进行分型。将所有患者按年龄段进行分组:16~20岁为1组,21~80岁每10岁为1组,81岁以上为1组,并统计各组骨折例数、构成比并进行对比。将成人胫骨平台骨折按Schatzker分型原则分为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ型,并按AO分型原则分为41-B、41-C型。2003年1月至2007年12月收治的患者资料定为A组,2008年1月至2012年12月诊治的患者资料定为B组,并进行两组对比。本研究中计数资料采用例数和百分比表示。应用SPSS 19.0统计学软件进行数据分析。两组患者性别、年龄及骨折类型的构成比等计数资料的比较采用?2检验,P0.05为差异有统计学意义。结果:2003年1月至2012年12月10年间河北医科大学第三医院共收治成人骨折107648例,其中成人胫腓骨骨折18432例,成人胫骨近端骨折3655例,成人胫骨平台骨折2004例。成人胫骨平台骨折占成人全身骨折的1.86%,占成人胫腓骨骨折的10.87%,占成人胫骨近端骨折的54.83%。男性1425例(71.11%),女性579例(28.89%),男女比例为2.5:1。41-50岁年龄段患者所占比例最高(25.65%)。AO分型骨折高发类型为41-B型(67.91%),Schatzker分型骨折高发类型为Ⅵ型(22.31%)。A组病例1033例,占成人全身骨折的1.86%(1033/55423),占成人胫腓骨骨折的10.09%(1033/10234),占成人胫骨近端骨折的54.11%(1033/1909)。其中男752例,女281例,50岁以上患者250例(24.20%)。B组病例971例,占成人全身骨折的1.86%(971/52225),占成人胫腓骨骨折的11.84%(971/8198),占成人胫骨近端骨折的55.61%(971/1746)。其中男673例,女298例,50岁以上患者310例(31.93%)。前后5年成人胫骨平台骨折占同期成人胫腓骨骨折的比例由10.09%上升至11.84%,有统计学差异(P0.001)。性别构成比无明显变化(P=0.085)。年龄构成发生变化:50岁以上患者的构成比由24.20%增加至31.93%,,有统计学差异(P0.001)。与A组比较,B组AO 41-B型骨折由64.96%增加至71.06%,C型骨折由35.04%减少至28.94%,差异有统计学意义(P=0.003)。SchatzkerⅡ、Ⅲ、Ⅳ、Ⅴ型构成比变化均有统计学意义(P0.001,P0.001,P=0.007,P0.001)。结论:本研究提示了2003年至2012年10年间成人胫骨平台骨折的流行病学特征及变化趋势,成人胫骨平台骨折占成人全身骨折的1.86%,占成人胫腓骨骨折的10.87%,占成人胫骨近端骨折的54.83%。男性多见,高发年龄段为41-50岁。AO分型41-B型骨折多见,Schatzker分型Ⅵ型骨折多见。与前5年比较,后5年成人胫骨平台骨折占同期成人胫腓骨骨折的比例、50岁以上患者构成比、AO 41-B型骨折构成比及SchatzkerⅢ型骨折构成比均增加。
[Abstract]:Objective: proximal tibial fractures of the tibial plateau belong to intra-articular fractures, is one of the more common lower extremity fractures, caused by high energy trauma may be associated with different degree of compression and displacement of the articular surface, the effect of knee joint on stability and movement. At present, the domestic research of the incidence and trend of adult tibial plateau fracture less therefore, we investigated the clinical data in our hospital 2003~2012 10 years adult tibial plateau fracture, and to compare the data before and after 5 years, in order to understand more comprehensive epidemiological characteristics of adult tibial plateau fracture, and analyzes its development trend. Methods: using medical image archiving and communication system (PACS) and access to all medical record query system the Third Hospital of Hebei Medical University from January 2003 to December 2012 adult treatment of fracture data. Inclusion criteria: fresh fractures, aged 16 years of age. Exclusion criteria: under the skull. The jaw, ribs, sternum, pathological fracture, old fracture fracture around the prosthesis, will be screened. All fractures were classified according to X-ray AO fracture classification principle. All the patients were grouped according to age: 16~20 year old for the 1 group, 21~80 years every 10 years into 1 groups over the age of 81 to 1 group, and calculated the number of fractures, the constituent ratio and compared. According to Schatzker classification principles were divided into adult tibial plateau fracture II, III, IV, V, VI, and according to the AO classification principle is divided into 41-B, 41-C type.2003 patient data from January to December 2007 were designated as A group of patients from January 2008 to December 2012 the clinical data set for the B group, and two groups were compared. The count data in this study indicated by the number of cases and percentage. Using SPSS 19 statistical software for data analysis. Two groups of patients with gender, age and fracture type and percentage of count data were compared by the 2 test? P0.05 test, the difference was statistically significant. Results: 107648 cases of fracture were treated from January 2003 to December 2012 10 adults in the Third Hospital of Hebei Medical University, including 18432 cases of adult tibial and fibular fractures, adult proximal tibial fractures in 3655 cases, 2004 cases of adult tibial plateau fracture. Adult tibial plateau fractures accounted for 1.86% of all adult fractures of tibia and fibula, accounting for adults fracture of the 10.87%, 1425 cases of 54.83%. male adult proximal tibial fractures (71.11%), 579 cases were female (28.89%), the proportion of men and women 2.5:1.41-50 years old age group the highest proportion (25.65%) of.AO type fractures in type 41-B type Schatzker type (67.91%), the most frequent fracture type (type VI 22.31%).A group of 1033 cases, accounting for 1.86% of all adult fractures (1033/55423), accounting for 10.09% of adult tibial and fibular fractures (1033/10234), accounting for 54.11% of the adult proximal tibial fractures (1033/1909). There were 752 male and 28 female In 1 cases, 250 cases of patients over 50 years old (24.20%).B group of 971 cases, accounting for 1.86% of all adult fractures (971/52225), accounting for 11.84% of adult tibial and fibular fractures (971/8198), accounting for 55.61% of the adult proximal tibial fractures (971/1746). There were 673 male and 298 female patients, 310 cases of 50 years old more patients (31.93%). After 5 years of adult tibial plateau fracture of tibia and fibula fractures accounted for the same period the proportion of adults increased from 10.09% to 11.84%, there was significant difference (P0.001). No significant changes in sex ratio (P=0.085). The age structure changes: 50 years old patients with constituent ratio increased from 24.20% to 31.93%. There were significant differences (P0.001). Compared with A group, B group and AO type 41-B fractures increased from 64.96% to 71.06%, type C fracture was reduced from 35.04% to 28.94%, the difference was statistically significant (P=0.003).Schatzker II, III, IV, constituent ratio changes were statistically significant (P0.001, P0.001, V P=0.007, P0.001) conclusion: this. This study suggests that the epidemiological characteristics and trends from 2003 to 2012 10 years of adult tibial plateau fractures, adult tibial plateau fractures accounted for 1.86% of all adult fractures, accounting for 10.87% of adult tibial and fibular fractures, proximal tibial fractures accounted for adult 54.83%. male, the age is 41-50 years old.AO type 41-B fractures. Schatzker, type VI fractures were more common. Compared with the previous 5 years, after 5 years of adult tibial plateau fractures accounted for the proportion of adult tibial and fibular fractures, proportion of patients over 50 years old, AO type 41-B fracture and fracture of Schatzker type were increased.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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