老年髋部骨折致伤因素临床分析  

Clinical analysis and study of injury factors in elderly patients with hip fracture

作　　者：王璞 王欢 牛舜 董川 张弘韬 王海鹏 马保安 Wang Pu;Wang Huan;Niu Shun;Dong Chuan;Zhang Hongtao;Wang Haipeng;Ma Baoan(Department of Orthopedics,The Second Affiliated Hospital,Air Force Medical University,Xi’an 710038,China)

机构地区：[1]空军军医大学第二附属医院(唐都医院)骨科,西安710038

出　　处：《创伤外科杂志》2022年第7期519-525,共7页Journal of Traumatic Surgery

基　　金：陕西省创新能力支撑计划资助项目(2021TD-45)。

摘　　要：目的 分析老年髋部骨折的临床病例资料并探讨其致伤因素。方法 回顾性分析2020年10月—2021年9月就诊于空军军医大学唐都医院骨科的140例老年髋部骨折病例资料,骨折组为临床诊断髋部骨折的老年患者,对照组150例为同期空军军医大学唐都医院体检中心未发生髋部骨折的老年体检人员。比较两组患者性别、年龄、受教育程度、发病时状态等因素的差异,用Logistics回归分析确定老年髋部骨折的致伤危险因素。结果 骨折组男性53例(37.9%),女性87例(62.1%);年龄60~98岁,平均76.2岁;92.1%为低应力骨折,随着年龄增长患者发病环境由室外为主(63.9%)逐渐转向室内为主(90.9%)。单因素分析显示,两组在年龄(P<0.001)、体质量指数(BMI)(P=0.008)、受教育程度(P=0.020)、脑血管/神经疾病史(P=0.004)、运动系统疾病史(P=0.036)、是否使用助行器(P=0.008)以及骨量减少或骨质疏松(P<0.001)方面,差异有统计学意义(P<0.05),多因素Logistics回归显示年龄(P<0.001)、性别(P=0.036)、体质量指数BMI(P<0.001)、受教育水平(P=0.006)、脑血管/神经疾病史(P=0.027)、骨量减少或骨质疏松(P=0.040)、运动系统疾病史(P=0.029)是老年髋部骨折高危因素。结论 老年髋部骨折发病由自身身体状况、心理状况、外部环境等多因素协同发病,医护人员应增加针对老人的健康宣传教育、加强老年人的心理疏导、劝导指引老年人积极治疗控制基础疾病、引导老年人合理预防骨质疏松,以期降低老年髋部骨折发病率。Objective By collecting the clinical data of elderly hip fractures,so as to analyze the injury factors of elderly hip fractures,and to provide clinical scientific basis for preventing the occurrence and prevention of elderly hip fractures.Methods The data of 140 elderly patients with hip fracture who were treated in the Department of Orthopaedics of Tangdu Hospital of Air Force Medical University from Oct.2020 to Sep.2021 were retrospectively analyzed and assigned in the fracture group.The control group consisted of 150 elderly people who had not suffered hip fracture in the Physical Examination Center of Tangdu Hospital of Air Force Medical University.The differences of gender,age,education level and state of onset were compared between the two groups,the risk factors of hip fracture in the elderly were determined by logistic regression analysis.Results There were 53 males(37.9%)and 87 females(62.1%)in this group,aged 60-97 years,with an average age of 76.2years.92.1%were low-stress fractures.As the age increased,the occurring environment of the patients changed from outdoor(63.9%)to indoor(90.9%).Univariate analysis showed statistical differences in age(P<0.001),BMI(P=0.008),education level(P=0.020),history of cerebrovascular/neurological disease(P=0.004),history of motor system disease(P=0.036),the use of walkers(P=0.008)and osteopenia or osteoporosis(P<0.001)between the two groups.Multivariate logistic regression showed that age(P<0.001),gender(P=0.036),BMI(P<0.001),education level(P=0.006),history of cerebrovascular/neurological disease(P=0.027),osteopenia or osteoporosis(P=0.040)and history of motor system disease(P=0.029)were high risk factors for hip fractures in the elderly.Conclusion The incidence of hip fracture in the elderly is coincident with many factors,such as their own physical condition,psychological condition and external environment.As medical staff,we should increase health education,strengthen psychological counseling for the elderly,guide the elderly to actively treat and control basic dis

关 键 词：髋部骨折 危险因素 老年 

分 类 号：R683.3[医药卫生—骨科学]