中国北方和南方地区2010—2011年60岁以上人群股骨转子间骨折流行病学对比

Epidemiological comparison of geriatric intertrochanteric fractures between north and south areas of China from 2010 to 2011

目的对比分析我国北方和南方2010~2012年60岁以上股骨转子间骨折的流行病学特点。方法利用医学影像计算机存档与传输系统及病案查询系统收集2010年1月-2011年12月北方地区与南方地区,共21所医院诊治的股骨转子间骨折资料。将北京市、吉林省、辽宁省、甘肃省、宁夏回族自治区定位北方组,广东省、湖南省、贵州省、广西省、云南省定位南方组。对比两组患者性别、年龄、骨折分型及侧别构成。结果共收集60岁以上股骨转子间骨折1563例,北方组903例,南方组660例。北方组男性344例,女性559例,男女比为1∶1.63;南方组男性252例,女性408例,男女比为1∶1.62。两组均为76~80岁年龄段构成比最高,北方组为26.2%(237/903),南方组为22.4%(148/660);61~65岁年龄段构成比最低,北方组为6.6%(60/903),南方组为4.2%(41/660)。31A2型骨折北方组为538例,南方组为432例,31A1型骨折北方组为264例,南方组为150例,31A3型骨折北方组为101例,南方组为78例,两组三种骨折分型的构成比差异具有统计学意义(c2=8.353,P<0.05)。北方组左侧骨折为431例(47.7%),右侧骨折为472例(52.3%);南方组左侧骨折为354例(53.6%),右侧骨折为306例(46.4%),差异有统计学意义(x^2=5.321,P<0.05)。结论 60岁以上股骨转子间骨折南方高龄女性构成比较北方高,31A2型骨折构成比较北方高;北方地区31A1型构成比较南方高;北方右侧骨折多于左侧,南方地区相反。

Objective To compare and analyze the epidemiological features of geriatric intertrochanteric fractures between Northern and southern China. Methods Data of pediatric patients with intertrochanteric fractures treated from January 2010 to December 2011 in 21 hospitals in northern and southern China were collected. Patients were divided into two groups: northern group covered hospitals in Beijing, and Liaoning, Jilin, Shanxi, Gansu, Ningxia Provinces compared to the southern group of Guangdong, Guangxi, Hunan, Guizhou, Yunnan Provinced. Gender, age, sides and fracture classification between two groups were compared. Results A total of 1563 cases were included, 903 cases in the northern group and 660 cases in the southern group. There were 344 males and 559 females in the northern group (M/F=1∶1.63), and 252 males and 408 females in southern group (M/F=1∶1.62). Both groups presented the same peak age interval of 76-80 years (with corresponding proportion of 26.2% (237/903) in northern group and 22.4% (148/660) in southern group). On the contrast, the valley age interval were both 61- 65 years (with corresponding proportion of 6.6% (60/903) in northern group and 4.2% (41/660) in southern group). Besides, 538 cases in the northern group were identified as type 31A2 fracture and 264 cases were type 31A1 compared to 432 cases and 150 cases in southern group, differences were statistically significant between two groups (c2=8.353, P<0.05). The proportion of fracture sides had significant differences between two groups (c2=5.321, P<0.05) as the northern group had 431 left fractures (47.7%) and 472(52.3% ) right fractures, commensurately, there were 354 left fractures (53.6% ) and 306(46.4% ) in southern group. Conclusion The proportion of elderly females patients (60 years) in southern group was higher than the northern group, same trend of proportion of 31A2 fractures while the northern group had more 31A1 fractures. The dominant fracture side in northern group were the right side different from the left side of southern group.