骨科医生重视骨质疏松性骨折的治疗及预防吗?

Do Orthopaedic Surgeons Regard the Treatment and Prevention of Osteoporotic Fractures?

目的调查骨科医生掌握骨质疏松症的相关知识,以及在处理骨质疏松性骨折患者时对患者骨质疏松症进行药物治疗的情况,以此促进医生重视对骨质疏松性骨折的治疗及预防。方法通过调查问卷的方式对北京市、东北地区、山东省、河北省、河南省等地一些～级医院的骨科医生进行调查,内容包括骨质疏松症相关知识,骨质疏松性骨折患者的骨质疏松症治疗状况等。结果在诊断方面,70.1%的医生认为,对骨质疏松症进行药物治疗之前应该先进行骨密度测定以确定诊断。53.5%的医生认为,患者的骨质疏松性骨折及他们所具有的骨质疏松危险因素(如吸烟、大量饮酒、绝经后女性等)是患有骨质疏松症的确切证据,应该进行药物治疗。38.6%的医生认为,在推荐患者对骨质疏松症进一步治疗前,应该对患者进行健康检查以确定患者是否有引起骨质疏松的其他原因。在治疗方面,74.8%的骨科医生认为,对骨质疏松性骨折患者的骨质疏松症应该进行药物治疗。在选择药物方面,赞成对骨质疏松症进行药物治疗的医生中,40.9%建议应用双磷酸盐,约45%的医生倾向于使用维生素D及钙剂。事实上,75.5%的骨科医生因为考虑到其他问题而没有对骨质疏松症进行药物治疗。结论尽管大多数的骨科医生都认为应该对骨质疏松性骨折患者进行除骨折以外的骨质疏松症治疗,但是还有相当多的医生并没有对患者进行骨质疏松症的药物治疗,他们认为由骨质疏松专科医生进行药物治疗更为妥善。

Objective The objective of this study is to survey the knowledge of orthopedic doctors about osteo-porosis and the treatments they performed to the patients who have osteoporosis accompanied by fragile fractures. It is expected to improve the medical care for the osteoporosis. Methods We investigated the informations of the knowledge about osteoporosis and the treatments for osteoporosis of patients with fragile fractures,which were got from some doctors of several hospitals with the criteria of Grade Ⅱ or Ⅲ in Peking,the northeasten region,Hebei province, Henan province and Shandong province by the means of anonymous questionnaires. Results In the aspect of diagnosis,70.1% of the doctors thought that the DXA should be taken to identify the diagnosis of osteoporosis before drug treatments. 53. 5% of them thought that significant fragile fractures and the clinical risk factors （smoking,alcohol abuse and postmenopause etc） were definite evidences of osteoporosis and the drug treatments should be undertaken. 38.6% of the doctors considered that health examinations should be taken to identify whether there was any other disease caused osteoporosis before futher treatments for osteoporosis were recommended. In the aspect of treatment, 74.8% of them thought that drug treatments for the osteoporotic patients who had fragile fractures should be carried out. 40.9 % of those doctors who agreed with drug treatments for osteoporosis preferred to use alendronate,and about 45% of them are prone to use Vitamin D and Calcium. In fact, 75.5% of these orthopedic doctors had never performed the drug treatments for osteoporosis because of the adverse events due to the medicine. Conclusion Although major orthopedic doctors had the agreement on the option that the treatments for osteoporosis should be undertaken besides those for fractures of the osteoporotic patients ;many doctors had never supplied the medical care to the osteoporotic patients. They thought it should be performed by the specialists on osteoporosis.