影响老年骨质疏松性髋部骨折术后功能康复的相关因素初探  

Correlative factors influencing the postoperative rehabilitation in senile patients with osteoporosis hip fractures

作　　者：陈鹏[1] 刘文和 颜林淋[3] 陈家玉[4] 郭志文[1] 唐新文[1] 胡伟文[1] 曹锡文[1] 李杨[1] 王福剑[1] 

机构地区：[1]湘南学院附属医院骨科,湖南郴州423000 [2]广东省珠海市第二人民医院骨科 [3]湘南学院附属医院超声诊断室 [4]湘南学院临床医学系

出　　处：《临床医学》2015年第5期9-12,共4页Clinical Medicine

基　　金：湖南省卫生厅课题(B2013-61)

摘　　要：目的探讨影响老年骨质疏松性髋部骨折术后功能康复的相关因素。方法分析2000年1月至2014年1月间206例老年骨质疏松性髋部骨折患者的相关临床资料,其中股骨颈骨折93例,股骨转子间骨折113例。评估对术后功能康复有重要影响作用的相关因素。结果本组206例均成功进行手术治疗,其中184例（89.3%）伤后1周内手术,22例（10.7%）伤后1周后手术,71例（34.5%）术后出现系统并发症,148例（71.8%）住院时间〈3周。本研究206例中失访5例,随访201例,术后随访10~38（14.6±2.7）个月。采用Sanders髋关节创伤后的功能评分系统评估疗效,优92例,良68例,可31例,差10例,优良率79.6%。经多元回归分析患者术前全身状况与术后并发症发生率及临床康复程度有明显的相关性。患者术前全身状态、营养状况、认知障碍、治疗方法、年龄、手术时机、复位质量、骨密度值是影响骨质疏松性髋部骨折术后功能康复的独立危险因素。结论老年骨质疏松性髋部手术治疗时要充分认识到这些独立因素对疗效的影响以指导临床治疗。Objective To investigate the correlative factors influencing the postoperative rehabilitation in senile patients with osteoporosis hip fractures. Methods Two hundred and six senile patients with osteoporosis hip fracture were treated with opera- tion from January 2000 to January 2014. There were 93 cases of femoral neck fractures, and 113 cases of femoral intertrochanteric fracture. The correlative clinical indexes were analyzed statistically in the series. The data was dealt with multivariate Logistic re- gression analysis to uncover the factors influencing on the outcome. Results All the patients achieved successful operation. One hundred and eighty-four cases （89. 3% ） were treated with operations within 1 week after the injury, and 22 cases （10. 7% ） were treated with operations beyond 1 week after the injury. The systematic complications postoperatively occurred in 71 cases （34. 5% ）. The length of hospital stay was less than 3 weeks in 148 cases（71.8% ）. Two hundred and one cases out of the 206 cases were followed-up. The period of follow-up ranged from 10 to 38 months[ （ 14. 6 ±2. 7）months]. The outcomes were excel- lent in 92 cases, good in 68 cases, fair in 31 cases, and poor in l0 cases, and the excellent and good rate was 79. 6% according to Sanders criterion. There was an obvious correlation among the preoperative general conditions and the post-operative complica- tions and the postoperative rehabilitation extent resulting from the data dealt with multivariate Logistic regression analysis. The correlative factors had an important influence on the early postoperative rehabilitation in senile patients with osteoporosis hip frac- tures such as the preoperative general body state, nutritional status, dysgnosia, therapeutic method age, the timing of surgery, reduction status, bone density. Conclusion The correlative factors must be paid attention in order to improve the curative out- comes of osteoporosis hip fractures in senile patients influencing on the postoperative rehabilitation

关 键 词：老年人 髋部骨折 功能康复 影响因素 

分 类 号：R687.3[医药卫生—骨科学]