老年髋部骨折患者致伤因素分析  

Analysis of injury factors in elderly patients with hip fractures

作　　者：原源[1] 范斌[1] 李晓玉[1] 吴新宝[2] 张萍[1] YUAN Yuan;FAN Bin;LI Xiaoyu;WU Xinbao;ZHANG Ping(Department of Cadre Health Care,Beijing Jishuitan Hospital,Beijing 100035;Department of Orthopedic Trauma,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院干部科,北京100035 [2]北京积水潭医院创伤骨科,北京100035

出　　处：《中国骨质疏松杂志》2020年第1期85-90,117,共7页Chinese Journal of Osteoporosis

基　　金：2015北京市医院管理局临床医学发展专项经费资助(ZYLX201506)

摘　　要：目的通过对老年髋部骨折病例分析,了解老年髋部骨折患者致伤因素,为预防髋部骨折提供依据。方法收集北京积水潭医院2015年9月1日至2016年8月31日老年髋部骨折住院病例570例,按照年龄、性别等对致伤因素进行分析。结果老年髋部骨折病例中男性167例(29.3%),女性403例(70.7%),平均年龄79.5岁(60~100岁)。老年髋部骨折患者中94.9%为低应力骨折,且随着年龄增长脆性骨折比例逐步升高;骨折地点随着年龄增高逐步由户外为主转为室内为主;患者在户外及室内客厅发生髋部骨折的时间段均以白天为主(8:00~20:00),卧室及卫生间发生髋部骨折的时间段均以晚上为主(20:00~6:00);髋部骨折地域不同,摔倒的主要原因亦有不同;570例患者中95.1%合并基础疾病,随着年龄的增长合并多种基础疾病的比例也逐步升高;多元回归分析进一步得出,存在呼吸系统基础疾病、中重度营养不良以及患者基础疾病数量是髋部骨折后新发急性疾病严重程度的独立危险因素。结论老年髋部骨折致伤原因包括自身因素、药物因素以及环境因素等多方面,医疗工作人员应做好预防摔倒宣教、积极控制基础疾病、纠正骨质疏松,以期降低髋部骨折风险。Objective To investigate the causes of hip fracture in elderly patients by analyzing the data of elderly hip fractures in our hospital,and to provide evidence for prevention of hip fracture.Methods A total of570 elderly patients with hip fractures hospitalized in the Beijing Jishuitan Hospital from September 1st,2015 to August 31st,2016were collected.The injury factors were analyzed according to age and gender.Results Among the hip fracture patients,167(29.3%)were male and 403(70.7%)were female,with an average age of 79.5 years old(60-100 years).Low-stress fracture presented in 94.9%of elderly patients with hip fractures,and the proportion of fragility fractures increased with age.The fracture site gradually changed from outdoor to indoor with age.The time period of the fracture was mainly in the daytime(8:00-20:00),whether in outdoor or in living room.The time period of hip fractures in the bedroom and bathroom was mainly in the evening(20:00-6:00).The main causes of falls were different corresponding to the area.Among 570 patients,95.1%had underlying diseases,and the proportion of multiple underlying diseases increased with age.Multiple regression analysis further indicated that the respiratory diseases,mild to severe malnutrition,and the number of underlying diseases were independent risk factors for the severity of new onset acute disease after hip fractures.Conclusion The causes of hip fracture in the elderly include self-factors,drug factors,and environmental factors.Medical staff should educate the prevention knowledge of falls,actively control the underlying diseases and correct osteoporosis,in order to reduce the risk of the hip fracture.

关 键 词：老年人 髋部骨折 脆性骨折 致伤因素 骨质疏松 

分 类 号：R683.3[医药卫生—骨科学]