宁波地区515例老年髋部骨折患者的临床特征

Clinical characteristics of the 515 elderly with hip fracture in Ningbo

目的：回顾性分析宁波地区515例老年髋部骨折患者的临床特点，为防治骨质疏松性骨折提供依据。方法2010年1月至2012年12月在宁波市第一医院、宁波市第二医院治疗的515例老年髋部骨折患者（男158例，女357例，年龄60岁～96岁）纳入本研究。按5岁为1个年龄段进行分组，分析患者性别、年龄、致伤原因、骨折类型，受伤时间、治疗方式、伴随疾病、住院费用、住院时间等情况。结果冬季（10月至1月）是老年人髋部骨折高发时期，老年女性髋部骨折病例数为男性的2.25倍，显著高于男性，男性患者髋部骨折发病的年龄高峰为70～80岁，女性发病高峰在75～85岁。515例老年髋部骨折患者中股骨粗隆间骨折236例，占45.8％；股骨颈骨折279例，占54.2％。跌倒是骨折主要原因，占89.3％。515例老年髋部骨折患者手术治疗率为78.3％，1年死亡率为3.2％。手术组1年死亡率低于保守治疗组的9.9％（ P＝0.004）。骨密度检测率为58.8％，其中T值＜-2.5 SD者占48.5％。结论跌倒是老年人髋部骨折的主要原因；骨质疏松是老年人髋部骨折的内在因素。

Objective To retrospectively analyze the characteristic of 515 elderly （158 cases of male, 357 cases of female , 60 years old to 96 years old ） with hip fracture in Ningbo .Methods From January 2010 to December 2012 , 515 cases of elderly hip fracture were treated in Ningbo First Hospital and Ningbo Second Hospital , grouped according to the age of each 5 years as one group.The information of all patients＆#39;sex, age, causes of injury, fracture site, time of injury, treatment, concomitant diseases , hospital costs and length of stay was analyzed .Results Old people had high incidence of hip fractures in winter （ October to January ） .Old women had higher incidence of hip fractures than old men, about 2.25 times.The hip fracture of old men occurred mainly in the age of 70 to 80 years.The hip fracture of old women occurred mainly in the age of 75 to 85 years, it was 5 years later than men.236 cases of intertrochanteric fractures, accounted for 45.7%;279 cases of femoral neck fracture , accounted for 54.1%.Falling was a major cause of injury, accounted for 89.3%.The rate of surgical treatment was 78.3%, 1-year mortality rate of 3.2%.The 1-year mortality of surgical group less than conservative treatment group （9.9%） （P=0.004）.Detection rate of bone density was 58.8%, which T less than -2.5 SD accounted for 48.5%.Conclusion Falling was the major cause of injury elderly hip fracture , osteoporosis was the intrinsic factor for elderly hip fracture .