摘要
目的探讨老年髋部骨折患者手术治疗后对侧髋部再骨折发生情况,并对其影响因素进行分析。方法选取老年髋部骨折206例作为研究对象,根据治疗方法不同将其分为手术治疗组(151例)和保守治疗组(55例)两组,比较两组出院后1年对侧髋部再骨折发生情况,并对老年髋部骨折151例手术治疗后对侧髋部再骨折发生的可能影响因素进行单因素和多元Logistic回归分析。结果出院后1年,手术治疗组对侧髋部再骨折发生率15.89%(24/151)低于保守治疗组对侧髋部再骨折发生率29.09%(16/55),差异有统计学意义(P<0.05)。单因素分析结果显示,年龄、骨质疏松程度、手术时机、合并基础疾病、术后卧床时间、术后功能锻炼及锻炼依从性是影响老年髋部骨折患者手术治疗后对侧髋部再骨折发生的因素(P<0.05或P<0.01)。多元Logistic回归分析结果显示,年龄≥70岁、重度骨质疏松、合并基础疾病、未术后功能锻炼及锻炼依从性差是影响老年髋部骨折患者手术治疗后对侧髋部再骨折发生的独立危险因素(P<0.01)。结论老年髋部骨折经手术治疗较保守治疗发生对侧髋部再骨折的概率低。年龄≥70岁、重度骨质疏松、合并基础疾病、未术后功能锻炼及锻炼依从性差是影响老年髋部骨折患者手术治疗后对侧髋部再骨折发生的独立危险因素。
Objective To investigate the incidence of refracture of contralateral hip after operation in elderly patients with hip fracture and to analyze its influencing factors. Methods A total of 206 elderly patients with hip fractures were enrolled in this study. They were divided into surgical treatment group(n=151) and conservative treatment group(n=55) according to the different treatment methods. The incidence of refracture of contralateral hip at 1 year after discharge in patients in the two groups was compared. Univariate and multivariate Logistic regression analysis was used to analyze the potential influencing factors of refracture of contralateral hip after surgical treatment in 151 elderly patients with hip fracture. Results At 1 year after surgery, the incidence of refracture of contralateral hip in the surgical treatment group was 15.89%(24/151), which was significantly lower than 29.09%(16/55) in the control group(P<0.05). Univariate analysis showed that age, severity of osteoporosis, timing of surgery, presence or absence of combined underlying diseases, postoperative bed rest time, functional exercise, and exercise compliance were the factors affecting the occurrence of refracture of contralateral hip in elderly patients with hip fractures after operation(P<0.05 or P<0.01). Multivariate logistic analysis showed that age over 70, severe osteoporosis, combination of underlying diseases, no functional exercise after operation, and poor exercise compliance were independent risk factors affecting the occurrence of refracture of contralateral hip in elderly patients with hip fractures after operation(P<0.01). Conclusion The incidence of refracture of contralateral hip after operation in elderly patients with hip fracture is lower, as compared with conservative treatment. Age over 70, severe osteoporosis, combination of underlying diseases, no functional exercise after surgery, and poor exercise compliance are independent risk factors for the occurrence of postoperative refracture of contralateral hip in elderly patients.
作者
吴迎春
刘丽丽
杨群
WU Ying-chun;LIU Li-li;YANG Qun(Department of Spinal Orthopedics,the Second Affiliated Hospital of Chengdu Medical College Nuclear Industry 416 Hospital,Chengdu 610081,China)
出处
《临床误诊误治》
2020年第5期75-79,共5页
Clinical Misdiagnosis & Mistherapy
基金
四川省卫生厅科研基金(130052)。
关键词
髋骨折
老年人
外科手术
术后再骨折
影响因素分析
术后功能锻炼
锻炼依从性
骨质疏松
Hip fractures
Aged
Surgical procedures,operative
Postoperative refracture
Root cause analysis
Postoperative functional exercise
Exercise compliance
Osteoporosis
