髋部骨折2342例流行病学分布特点的单中心分析

Epidemiological distribution characteristics of 2342 cases of hip fracture:a single center analysis

背景:加强对髋部骨折危险人群的早期预防,可有效降低髋部骨折的发生风险。流行病学研究可为此类患者临床防治工作提供指导。目的:回顾性分析山西医科大学第二医院2016-01-01/2018-12-31入院的髋部骨折患者流行病学分布特点。方法:收集2342例患者的年龄、性别、骨折类型、患者属地、受伤季节、致伤原因、手术方式、术中情况、血栓情况、住院时间、费用及入院至手术时间、体质量指数、合并症等信息,采用SPSS 26.0软件进行数据处理,分析髋部骨折的流行病学分布特点。结果与结论:①髋部骨折患者平均年龄(73.90±13.43)岁,80-90岁组患者最多,占29.97%;②髋部骨折冬季多见,股骨颈和股骨转子间骨折季节分布差异具有统计学意义;③摔伤导致髋部骨折最多,占88.13%;④2108例行手术治疗的髋部骨折患者中,股骨颈骨折主要选择髋关节置换术,占60.03%;股骨转子间骨折主要选择髓内固定,占92.04%;⑤2097例行血管彩超检查的髋部骨折患者中,32.38%(679/2097)的患者检查出下肢动静脉血栓,其中28.71%(195/679)的患者行下腔静脉滤器置入术;⑥髋部骨折患者平均住院时间(10.49±7.06)d,平均住院费用(4.63±3.14)万元;⑦股骨颈骨折平均平均住院费用,平均失血量、平均手术时长均比股骨转子间骨折少,差异有统计学意义;⑧股骨转子间骨折的患者比股骨颈骨折的患者整体偏瘦;⑨有44.41%髋部骨折患者合并心脑血管系统疾病;⑩结果提示,髋部骨折患者以老年人群为主,尤其是老年女性,随着年龄增加,股骨转子间骨折所占比例逐渐升高;摔倒是老年人髋部骨折的主要致伤原因。髋部骨折主要选择手术治疗,术前备血及围术期预防血栓形成可提高患者预后。

BACKGROUND:Early prevention of hip fracture can effectively reduce the risk of hip fracture in a high-risk population.Epidemiological studies can provide guidance for the clinical prevention and treatment of such patients.OBJECTIVE:To retrospectively analyze the epidemiological distribution characteristics of patients with hip fracture admitted to the Second Hospital of Shanxi Medical University from January 1,2016 to December 31,2018.METHODS:To collect the patient’s age,sex,fracture type,territorial,season for injury,causes,surgical procedure,intraoperative situation,blood clots,length of hospital stay,cost,and admission to operation time,body mass index,complications,SPSS 26.0 software was used for data processing to analyze the epidemiology of hip fracture distribution characteristics in 2342 patients.RESULTS AND CONCLUSION:The average age of patients with hip fracture was(73.90±13.43)years,and hip fracture mostly occurred in the 80-90 group,accounting for 29.97%.Hip fractures were common in winter,and there was a significant difference in the seasonal distribution of femoral neck and intertrochanteric fractures.Falls resulted in the most hip fractures,accounting for 88.13%.Among the 2108 patients with hip fractures who underwent surgical treatment,hip replacement was the major choice for femoral neck fractures,accounting for 60.03%;intramedullary fixation was the main choice for intertrochanteric fractures,accounting for 92.04%.Among the 2097 patients with hip fracture who underwent color Doppler ultrasonography,32.38%(679/2097)of the patients had arteriovenous thrombosis of the lower extremities,and 28.71%(195/679)of the patients had inferior vena cava filter implantation.The average hospitalization time of patients with hip fracture was(10.49±7.06)days,and the average hospitalization cost was(4.63±3.14)thousand yuan.The average hospitalization cost,average blood loss and average operation time of femoral neck fractures were significantly less than those of intertrochanteric fractures.Patients with intertrochanteric fractures were generally thinner than those with femoral neck fractures.The 44.41%of patients with hip fracture had cardiovascular and cerebrovascular diseases.These results indicate that hip fractures are mainly developed in the older adults,especially in elderly women.With the increase of age,the proportion of intertrochanteric fractures increases gradually.Falls are the main cause of hip fractures in the older adults.Surgical treatment is the main choice for hip fracture.Preoperative blood preparation and perioperative thrombosis prevention can improve the prognosis of patients.