痴呆与髋部骨折相关问题的探讨

Dementia and hip fractures

痴呆是一种以认知功能障碍及精神行为异常为主要特点的慢性进行性精神衰退疾病，主要影响记忆力、注意力、语言、动作和行为，预后较差，对社会及家庭可产生严重后果。髋部骨折同样好发于老年人，内因为骨质疏松，轻微外力即可导致骨折，预后较差，术后1年病死率为20％～40％。髋部骨折患者常常合并痴呆，如何处理此类患者是骨科及其他科室医生的难点。近年来，相对于更直接地威胁髋部患者生命的心肺疾病、血栓性疾病，痴呆还没有得到足够的重视。本文就髋部骨折与痴呆的相关问题进行综述。

Dementia, with a poor outcome, is a syndrome characterized by persistent impairment in cognitive function or behavioral abnormalities as evidenced by deficits in memory, attention, language, and motor activity. Hip fractures represent a widespread morbidity among the geriatric population, and fall is the main cause of osteoporotic fracture. The mortality after hip fracture reaches from 20% to 40% within one year after operation. Co-occurrence of dementia and hip fracture is a common challenge for orthopedic surgeons and other clin- icians involved in hip fracture care. Until recently, dementia in patients with hip fracture has been an issue that has received scant recognition compared with conditions considered to represent a more immediate threat to life, such as eardiopulmonary and thromboembolic diseases. This article reviews the current issues and available evidence concerning dementia in patients with hip fracture.