老年骨质疏松发生再次骨折的危险因素评估及护理干预

Risk factors assessment of re-fracture in elderly patients with osteoporosis and its nursing intervention

目的探讨影响老年骨质疏松患者再次发生脆性骨折的相关因素。方法选取2011年8月-2012年10月本院收治的119例老年骨质疏松初次脆性骨折患者作为研究对象,治疗结束后,所有研究对象均接受24个月的随访,根据随访期内是否再次发生脆性骨折将上述研究对象分为观察组与对照组,观察组患者53例,随访期内均再次发生脆性骨折,对照组患者66例,随访期内未发生脆性骨折。结果单因素分析显示,2组患者性别、体质指数(BMI)、合并冠心病、合并血脂代谢紊乱、初次骨折后手术治疗史、骨质疏松性骨折家族史相比差异无统计学意义(P>0.05);观察组年龄、长期大量吸烟、合并慢性骨关节病、合并糖尿病、合并高血压、合并脑血管病、经常使用糖皮质激素显著高于对照组(P<0.05),坚持户外活动、坚持饮用牛奶、抗骨质疏松治疗显著低于对照组(P<0.05)。非条件Logistic回归分析显示,年龄、合并糖尿病、合并脑血管病是影响老年骨质疏松患者再次发生脆性骨折的独立危险因素(P<0.05),抗骨质疏松治疗史是其独立保护因素(P<0.05)。结论老年骨质疏松患者再次发生脆性骨折的影响因素较多,通过针对性的干预措施,可以有效降低老年骨质疏松患者再次脆性骨折发生率。

Objective To investigate the related factors of brittle fracture in elderly patients with osteoporosis. Methods A total of 119 senile osteoporosis patients with initial brittle fracture in our hospital from August 2011 to October 2012 were recruited as the research objects,all subjects received 24 months of follow- up after treatment. All the patients were divided into observation group and control group according to whether brittle re-fracture occurred or not. All patients in the observation group（ 53 cases） appeared brittle re- fracture during follow- up,and patients in the control group（ 66 cases） didn＇t occurred brittle re-fracture during follow- up. Results Single factor analysis showed no significant difference in gender,body mass index（ BMI）,coronary heart disease,disorder of lipid metabolism,and surgery history after first fracture,family history of osteoporotic fracture（ P〈0. 05）. The age,long term heavy smoking,chronic bone and joint disease,diabetes,hypertension,complication of cerebral vascular disease,frequency usage of corticosteroids in the observation group were significantly higher than that in the control group（ P〈0. 05）. Adhere to the outdoor activities and milk drinking,and anti-osteoporosis treatment was significantly lower than that in the control group（ P〈0. 05）. Non conditional logistic regression analysis showed that age,diabetes mellitus,complicated with cerebral vascular disease were the independent risk factors of brittle re-fracture（ P〈0. 05）,the history of anti- osteoporosis therapy was an independent protective factor（ P〈0. 05）.Conclusion Brittle re-fracture in elderly patients with osteoporosis is affected by many factors. Intervention measures can effectively reduce the incidence of brittle re-fracture in elderly patients with osteoporosis.