430例髋部脆性骨折3年后随访调查分析

发布时间：2018-05-08 18:37

本文选题：骨质疏松 + 髋部骨折　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]回顾性分析髋部脆性骨折患者的部分流行病学分布特征。[方法]收集1344例2013年在云南省昆明市10所医院因髋部骨折住院患者信息,在所有髌部骨折的患者中脆性骨折例数为858例,占63.8%。收集髌部脆性骨折患者的基本信息,包括性别、年龄、骨折部位、治疗方式、手术方式、住院时长间、住院费用,基础疾病情况、住院期间并发症情况、骨折诱因等。[结果]①跌倒是导致髋部脆性骨折最常见的诱因,占92.6%。②有效随访患者430例,男性149例,占34.7%,女性281例,占65.3%,女性与男性总体比例1.88:1,女性明显多于男性,差异有统计学意义(P0.05);70～89岁之间骨折人数最多,占81.63%;股骨粗隆间骨折明显多于股骨颈骨折,差异有统计学意义(P0.05)。年龄、性别与骨折部位无明显相关性(P0.05)。③手术方式、基础疾病情况、就诊医院等级对住院时间无影响(P0.05);手术治疗及住院期间发生并发症可能延长住院时间,P0.05,差异有统计学意义。④手术方式、基础疾病情况与住院费用无明显相关性(P0.05);选择手术治疗、住院期间发生并发症及在三甲医院治疗是住院费用增加的可能原因,差异有统计学意义(P0.05)。[结论]①70～89岁是髋部脆性骨折的好发年龄,女性多于男性,骨折部位以股骨粗隆间多见,预防跌倒是预防髋部脆性骨折的重要环节。②选择手术治疗及合并并发症可能是导致住院时间延长及住院费用增加的原因。[目的]了解髋部脆性骨折患者骨折3年后死亡情况、患肢疼痛情况及生活自理能力,并探讨其可能的影响因素。[方法]电话随访所收集患者的死亡情况(死亡时间、死亡原因)、骨折后是否予骨质疏松治疗、骨折3年后患肢疼痛情况及生活自理能力,并进行分析。[结果]①骨折后3年总死亡人数164人,骨折后半年死亡率为17.44%,骨折后1年死亡率为25.35%,骨折后2年死亡率为31.46%,骨折后3年死亡率为36.74%。导致死亡的直接原因有心脑血管事件、肺部感染、多器官功能衰竭及其他。年龄、治疗方式的选择、骨折部位、骨折后是否予骨质疏松治疗可能是死亡的主要影响因素。②年龄、基础疾病及并发症情况是骨折后3年是否存在患肢骨痛的影响因素,P0.05;年龄、是否有并发症及是否予骨质疏松治疗是骨折后3年功能恢复情况的影响因素,P0.05。[结论]①髋部脆性骨折死亡率较高,应重视髋部脆性骨折患者基础疾病的治疗。年龄、骨折部位、治疗方式、骨折后是否予骨质疏松治疗可能是死亡的危险因素。②年龄、基础疾病情况、并发症情况可能与髋部脆性骨折后患肢疼痛情况相关。年龄、并发症情况及骨折后是否予骨松治疗与骨折后生活自理能力相关。
[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.

【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

【参考文献】