老年髋部骨折患者合并胸腰椎压缩骨折的诊断与治疗  

Diagnosis and treatment of the hip fracture with thoracolumbar spine compression fracture in the elderly patients

作　　者：孟桦[1] 刘宝戈[1] 费凯[1] 潘海涛[1] 

机构地区：[1]首都医科大学附属北京天坛医院骨科,北京100050

出　　处：《中国骨与关节杂志》2018年第2期155-157,共3页Chinese Journal of Bone and Joint

基　　金：北京市215学科骨干(2014-3-034)

摘　　要：目的探讨老年髋部骨折患者重视合并胸腰椎压缩骨折的必要性,应将胸腰椎X线片列为该类患者的常规检查项目,避免漏诊,并探讨其治疗方法。方法对2014年4月至2015年10月我科收治的71例老年髋部骨折患者进行回顾性分析,按是否合并胸腰椎压缩骨折进行分组,分为合并胸腰椎压缩骨折组(18例)和单纯髋部骨折组(53例)。采用独立样本t检验,与单纯老年骨质疏松性椎体压缩骨折患者进行比较。结果本组共71例,髋部骨折合并新鲜椎体压缩骨折患者18例,占比25.4%,远高于单纯老年骨质疏松性椎体压缩骨折发病率(1.16%),与单纯髋部骨折患者比较,术后3个月FIM评分(41.79±5.32 vs.42.38±6.65)差异无统计学意义(P>0.05)。髋部骨折合并新鲜椎体压缩骨折组患者术前及术后1周腰部VAS评分差异有统计学意义(P<0.05)。结论应重视髋部骨折患者存在合并胸腰椎压缩骨折的可能性,可针对髋部骨折及椎体压缩骨折一期完成手术,改善患者的生活质量。Objective To explore whether thoracolumbar spine compression fracture occurs in the elderly patients with hip fracture, and its treatment. X-ray should be listed as a routine examination to avoid missed diagnosis. Methods April 2014-October 2015, 71 patients were retrospectively analyzed. According to the occurrence of thoracolumbar spine compression fracture or not, all patients were divided into 2 groups. Independent Sample T test was conducted. Results were compared. Results Eighteen patients were of the hip fracture ＋ thoracolumbar spine compression fracture, accounting for 25.4% [ significantly higher than the incidence of the osteoporotic vertebral compression fracture（ 1.16%） ]. Compared with patients with simple hip fracture, no significant differences existed in FIM score（ 41.79 ± 5.32 vs. 42.38 ± 6.65） 3 months after the operation（ P 0.05）. Statistically significant differences existed in VAS scores preoperatively and 1 week postoperatively（ P 0.05）. Conclusions Attention should be paid to whether thoracolumbar spine compression fracture may occur in the elderly patients with hip fracture. Individualized treatment should be performed to improve the life quality.

关 键 词：髋 骨折 压缩性 胸椎 腰椎 老年人 

分 类 号：R683.2[医药卫生—骨科学] R683.4[医药卫生—外科学]