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1、老年骯部骨折术后对侧骯部再骨折的危险因素分析贺振年,徐洪伟,康信勇,顾杰,李永甫,郭剑,张斌(宁波市北仑区人民医院,浙江,宁波,315800)摘耍目的:探讨老年競部骨折术后再发对侧髓部再骨折的相关危险因素,为预防二次競部骨折提供临床依据。方法:回顾性分析2008年12月~2014年2月北仑区378例老年骯部初次骨折患者的资料,32例患者发现对侧骯部再骨折。根据患者术后有无对侧競部骨折分为骨折组和无骨折组,比较两组患者的年龄、性别、初次骨折类型、内固定方式、卧床时间、骨质疏松情况、合并内科疾病情况、术后功能锻炼、治疗的依从性、生活环境(农村/城市)和末次
2、随访时HaEs评分,对于P<0.05的因素进行logistic冋归性分析。结果:骨折组与无骨折组的年龄、骨质疏松情况、合并内科疾病情况、术后功能锻炼、医疗依从性及末次随访时Harris评分比较差界均有统计学意义(PV0.05)。多因素logistic分析结果显示:骨质疏松(O&6.793,P=0・001)、高龄(0/?二4.170,P二0.002)、合并内科疾病5=3.828,*0.005)、术后功能锻炼(O&0.297,P=0.005)以及医疗依从性(ObO.295,P=0.007)是老年髓部骨折术后对侧髓部再骨折的主要危险因素。结论:老年骯部骨折术
3、后对侧再骨折主要危险因素是高龄、骨质疏松、合并内科疾病、术后功能锻炼和医疗依从性。术后需加强抗骨质疏松治疗、积极治疗内科疾病,坚持功能锻炼,以预防骯部再次骨折的发生。关键词髓骨折;再骨折;老年;风险因素Analysisoftheriskfactorsofthecontra-lateralhipre-fracturesafterhipfractureinelderlypatientsZhennianHe,HongweiXu,XinyongKangjieGu,YongfuLi,JianGuo,BinZhangBeilundistrictpeople'sho
4、spitalofNingbo,NingBo,ZheJiang,315800ABSTRACTObjective:Toanalyzetherelatedfactorsofthecontra-lateralhipre-fracturesafterhipfracturesinelderlypatients,inordertoprovidebasisforthepreventionofsecondaryfractures.Methods:Aretrospectivestudywasconductedofthe378elderlypatientswithhipfr
5、acturewhohadbeentreatedatourdepartmentfromDecember2008throughFebruary2014inBeilundistrict.Alongthem,32patientshadthere-fracturesofthecontra-lateralhip.Theyweredividedintoare-fi^acturegroupandno-re-fracturegroupaccordingtopresenceorabsenceofre-fractureofthecontra-lateralhipafters
6、urgery.Aged,gender,fracturetype,internalfixationtype,bedtime,osteoporosis,combineddisease,postoperativefunctionaltraining,theraphycompliancetlivingenvironment(rural/town)andHarrisscoreatthelastfollow-upwerecomparedbetweenpatientswithorwithoutre-fractures.FactorswithP<0・05wereana
7、lyzedbymultivariatelogisticregression.Results:Thereweresignificantdifferencesbetweenthere-fracturegroupandtheno-fracturegroupinage,osteoporosis,combineddisease,postoperativefunctionaltraining,theraphycomplianceandHarrisscoreatthelastfollow-up(PV0.05).Themultivariatelogisticregre
8、ssionanalysisshowedthatosteoporosis(O7?=6.793,C