老年髋部骨折骨质疏松认知及诊疗现状问卷调查

The questionnaire about the cognition and the treatment of osteoporosis in hip fracture

目的了解髋部骨折患者对骨质疏松诊疗的认知情况及髋部骨折对患者的影响。方法对2009年6月至2011年6月在天津医院因髋部骨折住院、年龄>60岁的患者进行电话问卷调查。结果共检索出1796例>60岁的髋部骨折患者,其中529例有联系方式,78例脆性骨折患者或家属的联系方式有效且愿意接受调查。知晓自己有骨质疏松者为43例,不知晓者33例,2例未回答该问题。知晓患有骨质疏松组接受治疗者的百分比为58.14%,不知晓组为11.43%,知晓组有20.93%的患者服用药物时间>1年,不知晓组无服药时间>1年者。在接受抗骨质疏松治疗者中,单纯服用钙剂或联合活性维生素D者占73%,接受双膦酸盐者为11%,接受降钙素者为12%。因无人告知应服用多久而停药者占63%,没有人因为经济原因停药。不知晓组服用抗骨质疏松药物者占72%,担忧出现不良反应而未服药者为15%。骨折对生活无影响者占31%,生活能够自理但稍有影响者占28%,对生活影响较大且需要别人帮助者占15%,生活完全不能自理需要别人帮助者占14%,有9例患者死亡。对生活的满意度同骨折前者占39%,满意度稍差者为32%,生活比较痛苦者占23%,6%的患者认为生活相当痛苦。结论目前患者对骨质疏松的认知状况仍不能令人满意,明确诊断和告知患者其患有骨质疏松有助于治疗,髋部骨折对患者的生活有明显不利的影响。

Objective To investigate the cognition and the treatment of osteoporosis in hip fracture and the influence on the life after the hip fracture.Methods Questionaire was completed in the hip fracture patients older than 60 who admitting to our hospital since 1,June,2009 to 31,June,2011 in our hospital case documents record system.Complete the questionnaire which was designed by us by telephone.Results There were 1796 patients older than 60s with hip fracture in our case record system.In these,529 cases recorder included phone number.At last,there were 78 cases with hip fragile fracture entering the study whose phone number were available and agree to answering the question.43 patients knew they having osteoporosis and 33 did not know,another 2 person could not answer this question because they were the relative of the patients.58.14% patients accepted the treatment of antiosteoporosis in the knowing group and 11.14% in unknowing group.20.93% patients took the antiosteoporosis medicine over one year in the knowing group and non in unknowing group.In the patients who took anti-osteoporosis medicine,73% took calcium only or just combined with vitamin D,only 11% took bisphosphonates and 12% for calcitonin.63% patients stop taking the medicine because they did not know how long they should,no people stopped the treatment because of medical fee.72% patients who did not accept anti-osteoporosis treatment because that no one told they should take,15% patients＇ answers about this question were afraid of side effect.31% patients fell no influence on the life after fracture,28% answer that there are slightly influence on the life,15% feel difficult that need helping in some aspects of life because of the fracture.14% cannot self-care and 12% patients dead after discharge from the hospital.39% patients fell as same satisfaction about the life as before,32% fell less satisfied,23% feel unsatisfied compared with before,the rest fell extremely distress about the life after fracture.Conclusion It is not optimistic about the cognition among osteoporosis patients.The fracture brings extremely distress to the patients.Diagnosing and informing can improve treatment of osteoporosis.