老年骨盆脆性骨折病人再骨折预防管理的最佳证据总结  

The best evidence summary for the preventive management of recurrent fractures in elderly patients with pelvic fragility fractures

作　　者：赵旭 包丽沛 王安素 周钰凤 何剑平 邓淞月 ZHAO Xu;BAO Lipei;WANG Ansu;ZHOU Yufeng;HE Jianping;DENG Songyue(Nursing School of Zunyi Medical University,Guizhou 563000 China)

机构地区：[1]遵义医科大学护理学院,563000 [2]遵义医科大学附属医院,563000

出　　处：《全科护理》2025年第5期809-814,共6页Chinese General Practice Nursing

基　　金：2024年贵州省卫生健康委科学技术基金资助项目,编号:gzwkj2024-254。

摘　　要：目的:检索、整理、评价和总结老年骨盆脆性骨折病人再骨折预防与管理的相关证据,为临床实践提供循证依据。方法:遵循“6S”模型,计算机检索国内外相关指南、网站及中英文数据库中关于老年骨盆脆性骨折再骨折预防管理措施的相关文献,包括临床决策、指南、专家共识、证据总结、系统评价,并补充检索高质量的原始研究,检索时限为建库至2024年7月31日。由2名研究人员独立进行文献筛选和质量评价,并提取符合质量标准的文献证据。结果:共纳入文献13篇,包括指南7篇、专家共识5篇、系统评价1篇,从多学科团队管理、骨折风险评估与筛查、跌倒预防管理、营养干预、运动管理、药物管理及健康教育7个维度汇总29条证据。结论:总结了老年骨盆脆性骨折再骨折预防管理的最佳证据,建议临床人员结合医疗情境及病人自身情况等制订符合个体化、本土化的再骨折预防管理方案。Objective:To search,sort out,evaluate and summarize the relevant evidence of the prevention and management of refracture in elderly patients with pelvic fragility fracture,so as to provide evidence-based evidence for clinical practice.Methods:Guided by the "6S" model,electronic searches were systematically conducted across domestic and international guidelines,authoritative websites,and Chinese/English databases to identify literature on re-fracture prevention and management strategies for pelvic fragility fractures in older adults.The search encompassed clinical decision-making tools,guidelines,expert consensuses,evidence summaries,and systematic reviews,supplemented by additional searches for high-quality original studies.The search time was from the establishment of the database to July 31 2024.Literature screening and quality evaluation were conducted independently by two researchers,and literature evidence meeting the quality criteria was extracted.Results:A total of 13 literatures were included,comprising 7 guidelines,5 expert consensus and 1systematic review.29 pieces of evidence were summarized from 7 dimensions:multidisciplinary team management,fracture risk assessment and screening,fall prevention management,nutrition intervention,exercise management,pharmacological management and health education.Conclusion:This paper summarizes the best evidence of prevention and management of refracture of elderly pelvic fragility fractures,and suggests that clinicians should develop individualized and localized refracture prevention and management programs according to the medical situation and the patients' specific conditions.

关 键 词：老年病人 骨盆脆性骨折 骨质疏松 再骨折 证据总结 

分 类 号：R473.6[医药卫生—护理学]