北京海淀地区中老年妇女骨质疏松性骨折情况调查研究

The study of osteoporotic fractures in middle-aged and elder women in Haidian district in Beijing

目的通过调查北京海淀地区121例住院骨质疏松性骨折患者,探讨骨质疏松性骨折的危害及流行情况。方法选取121例于2008年1月至2012年12月在解放军第309医院全军骨科中心出院的中老年女性骨质疏松性骨折患者,年龄≥50岁,通过电话随访完成问卷调查,将结果统计分析。结果121例骨折患者,年龄71.41±10.35岁,平均住院天数15.69±10.67天,平均住院费用4.05±2.86万元;骨折原因中,跌倒所致占60.33%,日常活动所致占36.36%,其他原因占3.31%;出院后有14.88%的患者再次发生骨折。所有骨折患者中脊柱骨折98例,髋部骨折23例,两组的平均年龄分别为69.74±10.21和78.48±7.76岁,住院天数分别为13.62±7.95和24.48±15.58天,平均住院费用分别为3.79±2.73和5.15±3.20万元,骨折原因中,脊柱骨折组和髋部骨折组因跌倒所致分别为53.06%和91.3%,骨折后脊柱骨折组和髋部骨折组生活完全不能自理的分别为5.10%和21.74%,以上结果均具有统计学差异(P<0.05)。所有患者骨折前使用抗骨质疏松药物的占14.87%,未进行任何治疗的占85.13%;骨折后使用抗骨质疏松药物治疗的有62.81%,未进行任何治疗的占37.19%。结论50岁以上女性骨质疏松性骨折患者,跌倒是首要致病因素,其中髋部骨折比脊柱骨折平均住院日更长,花费更多,危害更大。所有患者骨折前后的骨质疏松诊断率、治疗率均不足。

Objective To discuss the damage and epidemiology of osteoporotic fractures by investigating 121 inpatients in Haidian district,Beijing. Methods A total of 121 middla-aged and elder women with osteoporotic fractures,who had discharged from the Center of Orthopedic in the 309^th Hospital of PLA from January 2008 to December 2012,were selected. The average age of the patients was 50 years old or above. All of the questionnaires were completed by the telephone follow-up,and then the data were analyzed. Results The average of age,length of stay,hospital fees were 71. 41 ± 10. 35 years,15. 69 ± 10. 67 days,and 4. 05 ±2. 86 ten-thousand yuans,respectively. The proportion of fall,daily activities,and other causes which lead to fractures were60. 33%,36. 36%,and 3. 31%,respectively. Re-fractures occurred in 14. 88% of the patients after discharge. There were 98 patients with spinal fractures and 23 patients with hip fracture. The average of age,length of stay,hospital fees of the two groups were 69. 74 ± 10. 21 and 78. 48 ± 7. 76 years,13. 62 ± 7. 95 and 24. 48 ± 15. 58 days,3. 79 ± 2. 73 and 5. 15 ± 3. 20 ten-thousand yuans,respectively. The proportion of fall leading to the fracture and the patients unable to do anything by themselves in spinal fracture group and hip fracture group were 53. 06% and 91. 3%,5. 10% and 21. 74%,respectively,and the difference between the two groups was significant（ P〈0. 05）. Only 14. 87% of the patients received anti-osteoporotic medications,and 85. 13% of patients didn＇t receive any treatment before fractures. 62. 81% of the patients received anti-osteoporotic medications,and 37. 19%of patients didn＇t receive any treatment after fractures. Conclusion The primary cause of the fracture is fall in middle-aged and elder women. The average of length of hospital stay,hospital fees,and the damage of the hip fracture are even worse than those in the spinal fracture. The diagnosis and medical treatment before and after the fractures are insufficient.