糖尿病外伤性骨折的营养及临床特点

Clinical characters and nutritional status of fractured patients with diabetes mellitus

目的探讨糖尿病(DM)外伤性骨折情况下,患者手术前后营养状况的变化及临床特点。方法回顾性分析96例接受手术的糖尿病外伤性骨折病例,作为DM组,选择同期入院,骨折手术无糖尿病96例,作为对照组,对临床生化指标,住院时间、费用以及并发症等进行统计学分析。结果骨折并存糖尿病患者,致伤原因以不慎摔倒为主,骨折多发于髋部(56%)。DM组与对照组比较,DM组术前血红蛋白和血浆蛋白高于对照组,差别有显著性(P<0.05),术后血浆蛋白下降幅度DM组明显大于对照组。与对照组比较,DM组的术前准备时间和总住院时间较长,差别具有显著性(P<0.01);药费及并发症的发生率也比对照组高,差别具有显著性(P<0.05)。结论糖尿病患者易发生髋部骨折,糖尿病骨折手术所引起的营养代谢消耗高于无糖尿病患者,故应重视糖尿病患者骨折术后营养,兼顾饮食控制与营养以改善预后减少并发症。

Objective To assess the clinical characters and nutritional status of fractured patients with diabetes mellitus （DM）. Methods 96 cases of operated fractures with DM （DM group） and 96 operated fractures cases without DM （control group） were reviewed. The difference among clinical observations, hospitalized length, medical cost and the incidence of postoperative complications were compared between two groups. Results The main cause of the fracture with DM was unwary fall, and the fractures were commonly affected in hip （56 % ）. The average amount of plasma protein and hemoglobin had significant difference in DM group before operation compared with the control group （P 〈 0.05 ）. The levels of serum albumin and pre-albumin decreased more significantly in DM group than in control group after operation （P 〈 0.05）. Compared with control group, DM group had a longer preoperative preparation period （P 〈 0.01 ）, higher medical cost and complications （P 〈 0.05）. Conclusion Diabetic patients easily affect fracture on hipbone and patients with diabetes are proved to suffer from higher metabolic usage than patients without diabetes after fracture operation. It is important to meliorate the nutritional status of DM patients for reducing the occurrence of fracture incidence and also improve the prognosis of DM patients with fractures.