骨质疏松性髋部骨折术后再骨折危险因素分析  

Analysis on risk factors of re-fracture after operation of osteoporotic hipfracture

作　　者：任磊[1] 孙永青[1] 郝敬东[1] 崔准[1] 韩云毅[1] 蒋育欣 靳凯峰 

机构地区：[1]首都医科大学电力教学医院骨科,北京100073

出　　处：《中国医师进修杂志》2017年第4期301-304,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨及分析骨质疏松性髋部骨折患者手术治疗后出现再次骨折的相关危险因素.方法 对247例接受手术治疗的骨质疏松性髋部骨折患者进行临床随访,根据术后是否出现再骨折分为再骨折组（54例）和非骨折组（193例）,对两组间的相关因素包括性别、年龄、体质量指数（BMI）、患侧、首次骨折部位、手术方式、围手术期实际失血量、术后短期谵妄、术后卧床时间、内科合并症、Charlson合并症指数、术后抗骨质疏松治疗、术后6个月随访时Harris髋关节功能评分及功能独立性评定（FIM）等进行单因素分析及多因素Logistic回归分析.结果 单因素分析和多因素Logistic回归分析结果显示,年龄、术后短期谵妄、合并高血压、合并糖尿病、合并脑血管病、术后抗骨质疏松治疗、术后6个月时Harris髋关节功能评分和FIM评分是影响骨质疏松性髋部骨折术后再骨折的危险因素（P＜ 0.05或＜0.01）.结论 骨质疏松性髋部骨折术后出现再骨折的危险因素包括年龄、术后短期谵妄、内科合并症等被动因素,以及术后抗骨质疏松治疗、术后关节功能康复情况等主动因素.术后患者需积极接受内科疾病的治疗,并增强抗骨质疏松的治疗和髋关节功能康复锻炼的主观能动性,以预防再骨折的发生.Objective To investigate and analyze risk factors of re-fracture after operation of osteoporotic hip fracture.Methods Two hundred forty-seven patients receiving operation of osteoporotic hip fracture were retrospectively studied and followed up,and all patients were divided into re-fracture group （54 patients） and no-re-fracture group （193 patients）.The related factors such as sex,age,body mass index （BMI）,affected side,initial fracture site,operation type,perioperative blood loss,postoperative delirium,postoperative bedridden time,medical complications,Charlson comorbidity index,antiostoporosis therapy,hip function scores with Harris and functional independence measurement （FIM） scores were compared by single factor analysis and multivariate Logistic regression analysis.Results Single factor analysis and multivariate Logistic regression analysis both showed that the risk factors of re-fracture after operation of osteoporotic hip fracture included age,postoperative delirium,hypertension,diabetes mellitus,cerebrovascular disease,antiostoporosis therapy,hip function scores with Harris and FIM scores （P ＜ 0.05 or ＜ 0.01）.Conclusions Risk factors of re-fracture after operation of osteoporotic hip fracture include passive factors of age,postoperative delirium and medical complications,and subjective factors of antiostoporosis therapy,hip function scores with Harris and FIM scores.Patients should receive medical treatment positively,enhance antiostoporosis therapy and rehabilitation training of hip function to prevent re-fracture.

关 键 词：骨质疏松 髋部骨折 再骨折 危险因素 

分 类 号：R687.3[医药卫生—骨科学]