【摘要】 目的了解2010年—2014年间复旦大学附属华山医院收治的60岁及以上的老年人骨质疏松性骨折患者的临床特点及预后,为临床工作提供指导和帮助。方法收集2010年1月至2014年12月之间华山医院收治的老年骨质疏松性骨折病例(年龄≥60岁)住院资料进行统计分析,包括骨折类型、年龄、性别、致伤原因等,电话随访治疗后满三年者的生存率、死因、认知功能、日常生活能力并与受伤前比较。结果共收集老年骨质疏松性骨折病例651例,发现:(1)总体发病平均年龄为(76.90±9.05)岁,男女比例为1∶2.72,男女发病年龄无统计学差异(t=1.413,P=0.158);(2)骨折类型中髋部骨折发生比例最高(占68.82%),股骨转子间骨折发病平均年龄高于股骨颈骨折,股骨颈和股骨转子间骨折两组的年龄均值有统计学差异(P<0.001);(3)89.15%的患者合并有其他疾病,伴发疾病越多的组别内采用手术治疗者比例越少并且平均住院天数相应延长;(4)骨折多发生于冬季(25.79%);(5)致伤原因以自己跌倒者占大多数(73.11%),致伤地点中超过一半为居家(60.48%);(6)髋部骨折累及左侧者比例高于右侧,肱骨骨折相反;腕骨骨折累及两侧比例相同,胸椎椎体骨折则以T12和T11为主,腰椎椎体骨折则常见于L1与L2;(7)髋部骨折患者认知功能和日常生活能力下降最明显,其三年内死亡率高于其他各组;(8)骨折死亡原因:肺部感染占首位;(9)股骨转子间骨折的骨折再发率最高。结论老年女性较男性更易发生骨质疏松性骨折,髋部骨折最为常见且多数累及左侧,股骨转子间骨折发病平均年龄高于股骨颈骨折,髋部骨折对患者生存寿命和生活质量危害最大、三年内死亡率最高;肺部感染占死亡原因首位;伴发疾病越多则接受手术机会越小且住院天数延长。更多还原

【Abstract】 Objective To investigate the clinical features and the prognosis of the elderly over 60 years old with osteoporotic fractures. Methods Clinical data of 651 patients( at the age of 60 years old and over) with osteoporotic fractures hospitalized in Huashan Hospital during the period from Jan., 2010 to Dec., 2014 were collected, including fracture types, age,sex and injury causes and statistical analysis was made; telephone follow-up was performed on survival, death causes, cognition and daily living ability among the patients having been operated on for over 3 years, ad their condition was compared with that before operation. Result A total of 651 elderly fractures were collected; the average age of disease onset was(76.90±9.05)years old with the sex ratio of 1: 2.72(M/F), and no statistical difference was found in onset age between the male and the female(t=1.413, P=0.158); hip fracture took up the biggest proportion in occurrence(68.82%); the average onset age of intertrochanteric fracture was older than that of femoral neck fracture(FFNF), the difference was of statistical significance(P<0.001); 89.15%of the cases were combined with other diseases, among the more diseases the cases combined with, the less operations were performed and the longer the duration of hospitalization was; most fractures occurred in winter(25.79%); self falling down was main cause in the cases(73.11%) and over half of the fractures took place at home(60.48%); the ratio of hip fracture involved in the left was higher than that in the right while that of humeral fractures was just the opposite; the ratio of wrist fractured in the left was same with that in the right; thoracic vertebral fractures mainly occurred in T12 and T11 while lumbar vertebral fracture in L1 and L2; cognition and daily living ability of the cases with hip fractures decreased most obviously and the death rate within 3 years after operation was the highest; lung infection was the key death cause; the fracture recurrence in cases with intertrochanteric fracture was the highest. Conclusions The female elderly are more prone to having osteoporotic fractures; hip fractures are the most common and mainly involved in the left; the average onset age of intertrochanteric fracture is higher than that of FFNF; hip fractures lead to greatest harm to the survival and quality of life and has the highest death rate within 3 years;lung infection places first in death causes; combination with more diseases means less opportunity for surgery and prolonged hospitalization duration.更多还原