腰痛患者768例骨质疏松和脊椎骨折诊断情况分析  

Analysis on osteoporosis and vertebral fracture diagnosis in 768 patients with lumbago

作　　者：刘茗露[1] 韩庆国[1] 丁振凯[1] 刘煜[1] 徐明志[1] 年越[1] 

机构地区：[1]解放军国防大学第二医院,北京100039

出　　处：《临床军医杂志》2013年第1期42-43,46,共3页Clinical Journal of Medical Officers

摘　　要：目的总结768例中老年腰痛患者骨质疏松和脊椎骨折的诊断、治疗经验。方法将年龄为50～85岁的768例中老年腰痛患者,按年龄段分为四组,应用Prodigy型双能X线骨密度仪,测定患者的L1～4及股骨上段(包括股骨颈,Ward’s三角及大转子)的骨密度值。摄胸腰椎正侧位片,并对结果进行分析。结果中老年腰痛患者L1～4、股骨颈、Ward’s三角和大转子四个部位骨密度显示:除大转子骨密度在70～79岁组与50～59岁组组间比较无明显统计学差异外(P>0.05),其他三个部位在70～79岁和80岁组与50～59岁组组间比较有明显统计学差异(P<0.01)。768例X线胸腰侧位片,发生压缩性骨折的总患病率为17.81%,50～59岁组为10.19%,80岁以上为40.00%,脊椎压缩性骨折随年龄增加呈直线上升。结论中老年腰痛多伴有骨质疏松或脊椎压缩性骨折,诊断时要依靠详尽的病史、体格检查、骨密度测定及影像学检查,建议中老年人定期进行健康查体,以预防和推迟骨质疏松或脊椎压缩性骨折的发生。Objective To summarize the diagnosis and treatment experience of osteoporosis and vertebral fracture in 768 middle-aged and elderly outpatients with lumbago.Methods A total of 768 middle-aged and elderly outpatients with lumbago were treated and their bone mineral density（BMD） of L1-4 and upper femur（neck,Ward＇s triangle,trochiter） was measured using digital X-ray absorptiometry.Results Bone densities of L1-4,collum femoris,Ward＇s triangle and trochiter showed that except trochiter（no significant differences between 70-79 and 50-59 years groups,P0.05）,there were significant differences in BMD of the other three measured sites between the group of 70-79 or over 80 years and the group of 50-59 years（P0.01）.Lateral thoracolumbar radiographs showed that the total incidence of vertebral compression fracture was 17.81%.The incidence of the group 50-59 years was 10.19%,and that of the group of over 80 years was 40.00%.Conclusion Most of middle-aged and elderly patients with lumbago are accompanied by osteoporosis and vertebral compression fracture.It is suggested that they should undergo physical examination in order that osteoporosis and vertebral compression fracture will be prevented.

关 键 词：中老年人 腰痛 骨质疏松 脊椎骨折 

分 类 号：R683.2[医药卫生—骨科学]