老年股骨颈骨折患者全髋关节置换术后衰弱状况

Weakness Condition in Elderly Patients with Femoral Neck Fracture After Total Hip Arthroplasty

目的观察老年股骨颈骨折患者全髋关节置换术后衰弱状况,并分析其发生的影响因素。方法选择2019年7月至2021年5月于郑州大学第一附属医院接受全髋关节置换术治疗的93例老年股骨颈骨折患者为研究对象,随访1个月时,采用Tilburg衰弱量表评估其衰弱状况并分组,分为发生组与未发生组,调查并记录患者一般资料及术后卧床时间、血清25-羟基维生素D[25-(OH)D]水平及家庭关怀度情况,分析老年股骨颈骨折患者全髋关节置换术后衰弱状况的影响因素。结果93例患者中,25例出现衰弱状况,占26.88%(25/93);发生组患者术后卧床时间≥1个月、家庭关怀度低/中等比率高于未发生组,血清25-(OH)D水平低于未发生组(P<0.05);经logistic回归分析结果显示,术后卧床时间≥1个月、家庭关怀度低/中等为老年股骨颈骨折患者全髋关节置换术后衰弱发生的影响因素(OR>1,P<0.05),血清25-(OH)D高表达为老年股骨颈骨折患者全髋关节置换术后衰弱发生的保护因素(OR<1,P<0.05)。结论术后卧床时间≥1个月、家庭关怀度低/中等为老年股骨颈骨折患者全髋关节置换术后衰弱发生的危险因素,血清25-(OH)D水平高为术后衰弱发生的保护因素。

Objective To observe the weakness condition of elderly patients with femoral neck fracture after total hip arthroplasty and to analyze its influencing factors.Methods Ninety-three elderly patients with femoral neck fracture who underwent total hip arthroplasty in the First Affiliated Hospital of Zhengzhou University from July 2019 to May 2021 were selected as the research objects.At one month’s follow-up,the weakness condition of patients was evaluated by Tilburg weakness scale and they were divided into occurrence group and non occurrence group.The general data,postoperative bed time,serum 25-hydroxy vitamin D[25-(OH)D]level and family care degree were investigated and recorded,and the influencing factors of weakness condition after total hip arthroplasty in elderly patients with femoral neck fracture were analyzed.Results Among the 93 patients,25 cases showed weakness,accounting for 26.88%(25/93).The proportions of postoperative bed rest time≥1 month,low or medium family care in occurrence group were higher than those in non occurrence group,and the level of serum 25-(OH)D was lower than that in non occurrence group(P<0.05).Logistic regression analysis results showed that postoperative bed rest time≥1 month and low or medium family care were the risk factors of weakness after total hip arthroplasty in elderly patients with femoral neck fracture(OR>1,P<0.05),and the high expression of serum 25-(OH)D was the protective factor of weakness after total hip arthroplasty in elderly patients with femoral neck fracture(OR<1,P<0.05).Conclusion Postoperative bed rest time≥1 month and low or medium family care are the influencing factors of weakness after total hip arthroplasty in elderly patients with femoral neck fracture,and the high level of serum 25-(OH)D is the protective factor of postoperative weakness.