怒江福贡地区陈旧性骨折发病率及其危险因素的调查研究

Investigation on the Incidence and Risk Factors of Old Fractures in Fugong Area of Nujiang River

目的:探讨云南怒江福贡地区陈旧性骨折发病率流行现状及其危险因素,采取针对性预防措施、精准扶贫。方法:通过当地病案信息中心,提取国际疾病分类ICD-1O字典库S00-S99和T00-T88、T90-T98类目中所有四肢骨折病例资料及在访问调查中发现未到过医院就诊的,在本地区发生的所有四肢骨折患者。统计规定时间段,所有四肢骨折患者数量及发病率。并根据病史、影像资料对抽取的病例资料进行陈旧性骨折诊断标准进行明确诊断、统计发病率。将符合陈旧性骨折诊断标准的病例,分类为傈僳族、怒族、汉族、其他。进行危险因素探讨,制定防范措施。结果:研究对象2581例,其中陈旧性骨折1055例。陈旧性骨折发病率40.9%,其中男性的患病率为45%(798/1769),女性的患病率为31%(257/812)。儿童少年加青壮年患病率42.5%(749/1764);傈僳族44.6%(748/1679),怒族36.6%(305/833),汉族0,其他3.3%(2/60)。单因素分析结果显示,存在四肢陈旧性骨折与不存在四肢陈旧性骨折患者的性别、年龄段、民族、是否有农村合作医疗、生活习惯、宗教信仰、文化程度、居住地域条件、经济条件、初次损伤原因、初次就医情况、区域医疗条件比较,差异均有统计学意义(P<0.05)。logistic回归结果显示:民族、宗教信仰、文化程度、居住地域条件、初次就医情况、区域医疗条件是四肢陈旧性骨折的危险因素(P<0.05)。结论:怒江福贡地区陈旧性骨折高发病率与当地地域特点密切相关,医疗扶贫中切实采取防治措施,实现健康脱贫。

Objective:To investigate the prevalence and risk factors of old fractures in Fugong area,Nujiang River,Yunnan,and to take targeted preventive measures and targeted poverty alleviation.Method:Through the local medical record information center.Extract the data of all limb fracture cases in the S00-S99 and T00-T88,T90-T98 categories in the International Classification of Diseases ICD-10 dictionary library,and find all limb fracture patients in the region who have not been to the hospital during the interview investigation.Statistics of the number and incidence of all limb fracture patients during the specified time period.According to the medical history and imaging data,the extracted case data were used to make a clear diagnosis of the old fracture diagnostic criteria,and the incidence rate was calculated.The cases that meet the diagnostic criteria for old fractures are classified into Lisu,Nu,Han,and others.Explore the risk factors and formulate preventive measures.Result:Among 2581 patients,1055 patients were old fractures.The incidence of old fractures was 40.9%,with 45%(798/1769)in males and 31%(257/812)in females.The prevalence rate of children,adolescents and young adults was 42.5%(749/1764).44.6%(748/1679)of Lisu,36.6%(305/833)of Nu,0 of Han,and 3.3%(2/60)of others.Single factor analysis results showed that the existence of old fracture limbs with no arms and legs of old fracture patients’gender,age,nationality,if there was a rural cooperative medical care,living habits and customs,religious beliefs,cultural degree,geographical conditions,economic conditions,initial damage reasons,the first medical situation,regional health conditions,differences were statistically significant(P<0.05).Logistic regression results showed that ethnic group,religious belief,educational level,living area,first medical treatment and regional medical conditions were risk factors for old limb fractures(P<0.05).Conclusion:The high incidence rate of old fracture in Fugong area of Nujiang River is closely related to the local regional characteristics.The prevention and treatment measures should be taken in the medical poverty alleviation to realize the healthy poverty alleviation.