老年骨质疏松性骨折术后再骨折的流行病学调查

Epidemiological investigation of refracture after osteoporotic fractures in the elderly

目的探讨老年骨质疏松性骨折术后再骨折的发病特点。方法回顾性分析自2005-07—2018-07诊治的345例骨质疏松性骨折手术后再骨折。利用电子病案查询系统及医学影像计算机存档与传输系统记录、分析患者的基本信息,比较男性与女性老年骨质疏松性骨折手术后各个骨折部位出现再骨折的概率。结果结果345例均完成调查,女性(81.7%)患者的数量较男性(18.3%)多,69.9%的患者骨密度T值≤-2.5 SD,脊柱(64.1%)是发病率最高的骨折部位。女性髋部、肱骨近端骨折发病率高于男性,差异有统计学意义(P<0.05)。摔伤(64.6%)是最主要的致伤原因。64.35%的患者出现再骨折的时间为首次手术后1~5年,仅有11.0%的患者首次手术后规律服用抗骨质疏松药物。15.1%的患者每周运动次数≥2次。结论老年骨质疏松性骨折术后再骨折多发生于女性群体,骨折部位以椎体骨折最常见,首次骨折术后5年内再骨折发生率为77.9%,首次骨折后患者进行抗骨质疏松治疗的依从性较差。

ObjectiveTo investigate the characteristics of re-fracture after osteoporotic fractures in the elderly.MethodsA retrospective analysis was performed on 345 patients with osteoporotic fractures who underwent treatment from July 2005 to July2018.The electronic medical record system and picture archiving and communication system were used to extract and record the basic information of the patients,incidence of re-fracture following initial osteoporotic fractures between males and females were also compared.ResultsThree hundred and forty-five patients were completed the survey,and there were more female patients(81.7%)than males(18.3%).The bone mineral density(BMD)of 69.9%patients was less than-2.5 SD,and spine was the part with the highest incidence of re-fracture after osteoporotic fractures(64.1%).The incidence of hip fractures and proximal humeral fracture in female was higher than that in male,the difference was statistically significants(P<0.05).Fall(64.6%)was the main cause of the injury.64.35%of the patients suffered from re-fracture in 1 to 5 years after the first operation,and only 11.0%of those patients took anti-osteoporosis drugs regularly after the first injury,and 15.1%of patients exercised twice or more a week.ConclusionPostoperative re-fracture of osteoporotic fractures in the elderly occurs mostly in female groups,and vertebral fractures are the most common fracture site.The rate of re-fracture within 5 years after the initial fracture is 77.9%,and the compliance of anti-osteoporosis treatment after the first fracture is poor.