老年脆性骨盆骨折围术期治疗的热点问题

Perioperative hot issues for fragility fractures of the pelvis in the elderly

老年脆性骨盆骨折(FFP)发病率逐渐增加,致残率和病死率较高,成为威胁老年患者生命的又一类损伤。由于老年人普遍存在骨质疏松、慢性内科疾病和失能状况,因此,FFP的诊治有着特殊性,特别是围术期的处理较其他人群更为困难。FFP与青壮年骨盆骨折高暴力致伤机制不同,其骨折形态和分类不同,手术治疗目的是稳定骨盆环的力学传递结构,改善临床症状,减少长期卧床相关并发症,恢复无痛状态的日常自理生活。近年来骨盆骨折的手术治疗获得明显进步,但针对FFP的治疗尚存在争议。笔者就FFP围术期的热点内容进行探讨,以期实现FFP的规范化管理。

The incidence of fragility fractures of the pelvis(FFP)in elderly patients has been gradually increased.FFP has become another type of injury that threatens the lives of elderly patients because of high disability rate and mortality.The special physical condition of the elderly patients such as osteoporosis,chronic medical diseases and disability determines the specialty in diagnosis and treatment of FFP.The perioperative treatment is more difficult than other patients.FFP in elderly patients is different from the high violent mechanism of pelvis fractures in young patients,and its fracture morphology and classification are also varied.Surgical treatment is to stabilize the mechanical transmission structure of the pelvic ring,improve clinical symptoms,reduce long-term bed-related complications and restore painless daily self-care.In recent years,the surgical treatment of the pelvic fractures has made significant progress.However,there still remains controversy in treating FFP in elderly patients.The authors discuss the perioperative hot issues on FFP in elderly patients,hoping to realize the standard management of FFP.