| 老年髋部骨折综合治疗模式的前瞻性病例对照研究 |
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Received:March 31, 2014
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| 期刊信息：《中国骨伤》2014年27卷，第7期，第570-574页 |
| DOI：10.3969/j.issn.1003-0034.2014.07.009 |
| 基金项目:上海市浦东新区卫生系统重点学科（编号：PWZxK2010-08） |
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目的：对比老年髋部骨折综合治疗与传统治疗的临床疗效。
方法：自2011年2月至2012年12月，采用前瞻性方法入选老年髋部骨折患者300例，随机分为综合治疗组与传统治疗组，经筛选最终综合治疗组148例，男62例，女86例；年龄60～88岁，平均（78.76±7.32）岁；股骨粗隆间骨折45例，股骨颈骨折103例；Singh指数≥Ⅳ级74例，Singh指数<Ⅳ级74例；术前Harris评分39.90±2.28.传统治疗组146例，男60例，女86例；年龄66～96岁，平均 （80.00±7.06）岁；股骨粗隆间骨折50例，股骨颈骨折96例；Singh指数≥Ⅳ级75例，Singh指数<Ⅳ级71例；术前Harris评分40.10±2.81.观察比较两组患者术前一般情况、下地活动时间、住院时间、术后12周Singh指数≥Ⅳ级的发生率及DPD/Cr值、术后12个月的Harris评分及再骨折的发生率。
结果：综合治疗组140例获得随访，时间12～18个月，平均（14.80±1.85）个月；传统治疗组132例获得随访，时间12～14个月，平均（12.75±0.79）个月。综合治疗组住院时间、下地活动时间、术后12周DPD/Cr值及术后12个月Harris评分均明显优于传统治疗组（t=1.326，3.870，7.657，2.290，P<0.05）；而术后12周Singh指数≥Ⅳ级的发生率高于传统治疗组，术后12个月再骨折的发生率低于传统治疗组（χ2=30.869，4.346，P<0.05）.
结论：老年髋部骨折综合治疗组较传统治疗组的抗骨质疏松效果理想，与康复科合作的综合治疗模式为进一步完善老年髋部骨折治疗提供了循证医学参考。 |
| [关键词]:髋骨折 骨质疏松 老年人 病例对照研究 |
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| Prospective case-control study on comprehensive treatment for elderly hip fractures |
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Abstract:
Objective: To discuss the curative effect of traditional treatment and combination therapy for senile hip fracture.
Methods: Using prospective methods to choose 300 cases of elderly patients with hip fractures from February 2011 to December 2012,which were randomly divided into comprehensive treatment group and conventional treatment group. After screening,148 case were in comprehensive treatment group,including 62 males and 86 females with an average age of (78.76±7.32) years old ranging from 60 to 88; 45 cases were intertrochanteric fracture of femur,103 cases were fracture of neck of femur; Singh index≥Ⅳ in 74 cases,<Ⅳ in 74 cases;preoperative Harris score was 39.90±2.28. There were 146 cases in conventional treatment group,including 60 males and 86 females with an average age of (80.00±7.06) years old ranging from 66 to 96; 50 cases were intertrochanteric fracture of femur,96 cases were fracture of neck of femur; Singh index≥Ⅳ in 75 cases,<Ⅳ in 71 cases; preoperative Harris score was 40.10±2.81. Preoperative general situation,leaving bed time and hospital stay,the incidence of postoperative 12 weeks Singh index≥Ⅳ and DPD/Cr value,Harris score at 12 months after operation and the incidence of fracture again of two groups were observed and compared.
Results: In comprehensive treatment group 140 patients were followed up for 12 to 18 months with an anverage of 14.80±1.85. In conventional treatment group 132 patients were followed up for 12 to 14 months with an average of 12.75±0.79. There were no significant differences in age,gender,the classification of fracture,preoperative Harris hip score,preoperative Singh index≥Ⅳ level and DPD/Cr value between the two groups (P>0.05). Comprehensive treatment group had shorter leaving bed time and hospital stay,smaller postoperative 12 weeks DPD/Cr value and higher postoperative Harris score,higher incidence of postoperative 12 weeks Singh index≥Ⅳ level,lower incidence of fracture again than conventional treatment group,there was statistically significant difference between two groups (P<0.05).
Conclusion: For the anti-osteoporosis effect,the comprehensive treatment group has more advantage than traditional treatment group in elderly hip fracture,which can further improve the elderly hip fracture treatment and provide the reference of evidence-based medicine cooperate with rehabilitation department. |
| KEYWORDS:Hip fractures Osteoporosis Aged Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赵义荣,梁旭,杨铁毅,刘粤.老年髋部骨折综合治疗模式的前瞻性病例对照研究[J].中国骨伤,2014,27(7):570~574 |
| 英文格式: | ZHAO Yi-rong,LIANG Xu,YANG Tie-yi,LIU Yue.Prospective case-control study on comprehensive treatment for elderly hip fractures[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(7):570~574 |
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