高脂血症病人股骨颈骨折分型的临床研究  

The clinical research of femur neck fracture type in hyperlipidemia patients

作　　者：邱高高 殷慧琳 李作宏 张继平 张伟强[2] QIU Gao-gao;YIN Hui-lin;LI Zuo-hong;ZHANG Ji-ping;ZHANG Wei-qiang(Second Department of Orthopaedics and Traumatic Surgery,the Second People＇s Hospital of Yichang,Yichang 443000,China)

机构地区：[1]宜昌市第二人民医院骨外二科,湖北宜昌443000 [2]云南省中医医院骨科,昆明650011

出　　处：《骨科》2018年第6期469-473,共5页ORTHOPAEDICS

基　　金：云南省自然科学基金(2011FZ266)

摘　　要：目的探究高脂血症病人股骨颈骨折的分型特点。方法将2012年8月至2017年11月在湖北省宜昌市第二人民医院骨外科和云南省中医医院骨科诊断为股骨近端骨折并符合纳入标准的196例病人作为研究对象,分为高血脂组(97例)和血脂正常组(99例)。根据股骨颈骨折部位及股骨转子间Evans骨折分型判断各例病人的骨折类型。入院及出院时分别检测各例病人的总胆固醇及低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)水平,将高血脂组按照高血脂病程分为短期组(≤1年)、中期组(>1年,≤3年)和长期组(>3年)。探究血脂水平与股骨颈骨折分型之间的潜在规律。结果高血脂组股骨颈骨折者81例(83.5%),显著高于血脂正常组的67例(67.7%),差异有统计学意义(χ~2=6.638,P=0.010);长期组以颈中型骨折(19例,61.3%)最为多见,与短期组(1例,6.7%)、中期组(12例,23.5%)相比,差异有统计学意义(χ~2=12.973,P=0.004;χ~2=16.413,P均<0.001)。高血脂组中,中、长期组血脂水平(总胆固醇、LDL-C)均高于短期组,差异均有统计学意义(P均<0.05)。结论合并长期(>3年)高脂血症的股骨颈骨折病人中,以股骨颈颈中型骨折较为多见。Objective To investigate the clinical characteristics of femur neck fracture types in hyperlipidemia patients. Methods From August 2012 to November 2017 in the traumatology and orthopedic department in the two hospitals （the Second People＇s Hospital of Yichang, and Yunnan TCM Hospital）, 196 cases diagnosed as proximal femoral fracture complying with the absorbing standards were selected, and divided into hyperlipidemia group （97 cases） and common lipid group （99 cases）. The accurate diagnosis was judged according to locations of femoral neck fracture and the Evans types of intertrochanteric fracture of femur. The total cholesterol and low density lipoprotein cholesterol （LDL-C） levels in serum of each case were tested at the admission and discharge of hospital （getting the average values）. According to the disease duration of hyperlipidemia, the hyperlipidemia patients were divided into short-time group （≤1 year）, media-time group （〉1 year, ≤3 years） and long-time group （〉3 years）. Then, the characteristics of femur neck fracture types in hyperlipidemia patients were investigated. Results The incidence of femoral neck fracture in hyperlipidemia group （81 cases, 83.5%） was significantly higher than in common lipid group （67 cases, 67.7%） （χ^2=6.638, P=0.010）. Among the hyperlipidemia groups, the incidence of media femoral neck fracture type was highest in longtime group （19 cases, 61.3%）, vs. the short-time group （1 case, 6.7%） and media-time group （12 cases, 23.5%）（χ^2=12.973, P=0.004; χ^2=16.413, P〈0.001）. Among the hyperlipidemia groups, the blood lipid levels in mediatime group and long - time group were significantly higher than that in the short - time group （P〈0.05）.Conclusion Among the hyperlipidemia groups, long-time group （〉3 years） might be characteristic in media femoral neck fracture type for femoral neck fractures.

关 键 词：高脂血症 股骨近端骨折 股骨颈骨折 Ward三角 骨质疏松 

分 类 号：R683[医药卫生—骨科学] R589.2[医药卫生—外科学]