髋部脆性骨折患者诊治现状调查及再骨折危险因素分析

发布时间：2018-04-09 07:35

本文选题：骨质疏松　切入点：诊治现状　出处：《昆明医科大学》2017年硕士论文

【摘要】：[目的]调查髋部脆性骨折患者诊治现状,探讨髋部脆性骨折患者发生再骨折的危险因素,为骨质疏松性骨折及再次骨折的预防提供临床依据。[方法]2013年1月至2013年12月期间昆明市区10所公立医院因髋部脆性骨折住院的患者,3年后所有研究对象均使用统一调查表进行电话随访,随访有效430例,电话随访患者目前生存情况、诊治现状,调查患者是否行骨密度检测诊断骨质疏松,出院后骨质疏松治疗情况及患者对于药物的依从性;其中发生再次骨折的58例为病例组,未发生再次骨折的372例为对照组,分析各种相关因素对发生再次骨折的影响,包括年龄、性别、合并的内科疾病种类、是否行骨质疏松治疗。采用SPSS 21.0版软件包,运用卡方检验、t检验、二元logistic回归分析等统计方法,辨别和检验这些因素与骨质疏松性再次骨折的关系。[结果]1、髋部脆性骨折患者骨密度检测率为15.8%,骨质疏松诊断率为28.8%,骨质疏松治疗率为39.9%,抗骨质疏松治疗率为2.5%;2、髋部脆性骨折患者骨折后3年内再骨折率为13.5%;经卡方检验、t检验、二元logistic回归分析等统计学方法得出:髋部脆性骨折患者发生再次骨折的主要危险因素有:女性、合并糖尿病、合并神经系统疾病(P0.05,OR1)。[结论]临床医生对于髋部脆性骨折后骨质疏松的重视度不够,诊断率及治疗率均低,其中抗骨质疏松治疗率仅2.5%;本研究发现:女性、合并糖尿病、神经系统疾病为髋部脆性骨折患者再次骨折的主要危险因素。
[Abstract]:[objective] to investigate the status of diagnosis and treatment of fragile hip fracture, to explore the risk factors of refracture in patients with fragile hip fracture, and to provide clinical basis for the prevention of osteoporotic fracture and refracture.[methods] from January 2013 to December 2013, all patients with brittle fracture of hip in 10 public hospitals in Kunming city were followed up by telephone with unified questionnaire three years later. 430 patients were followed up effectively.The current survival, diagnosis and treatment of the patients were followed up by telephone. Whether the patients were diagnosed by bone mineral density (BMD), the treatment of osteoporosis after discharge and the compliance of the patients with drugs were investigated. Among them, 58 cases with refracture occurred in the case group.372 cases with no refracture were used as control group. The influence of various related factors on the occurrence of refracture was analyzed, including age, sex, the types of internal diseases associated with it, and the treatment of osteoporosis.Using the software package SPSS 21.0, using chi-square test / t test and binary logistic regression analysis to identify and test the relationship between these factors and osteoporosis refracture.[results] 1. The bone mineral density (BMD) detection rate, osteoporosis diagnosis rate, osteoporosis treatment rate, anti-osteoporosis treatment rate and refracture rate in patients with fragile hip fracture were 15.8, 28.8, 39.9 and 2.5 respectively, and the rate of refracture within 3 years after fracture in patients with fragile fracture of hip was 13.5%.Binary logistic regression analysis and other statistical methods showed that the main risk factors for refracture in patients with fragile hip fracture were: female, complicated with diabetes, and complicated with nervous system disease (P0.05 OR1).[conclusion] the clinicians pay less attention to osteoporosis after brittle hip fracture, the diagnostic rate and treatment rate are low, and the anti-osteoporosis treatment rate is only 2.5%.Nervous system disease is the main risk factor for refracture in patients with fragile hip fracture.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R683

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