摘要
目的:比较单纯骨科牵引和手术治疗与在其基础上辅以抗骨质疏松治疗对老年髋部骨折远期效果的影响。方法:选择1999-09/2004-01广州医学院第二附属医院及广州市第六人民医院骨科住院的新鲜(2周内)老年髋部骨折患者206例,男84例,女122例;年龄60～89岁。根据患者自愿原则将患者分为单纯骨科治疗组(单纯骨科牵引治疗28例:采取传统的牵引治疗;单纯手术治疗41例:采用一般骨科手术治疗)和综合治疗组(牵引+抗骨质疏松治疗49例,手术+抗骨质疏松治疗88例:单纯牵引和手术治疗基础上给予抗骨质疏松治疗,抗骨质疏松症治疗包括饮食调整、抗骨质疏松西药应用、中药治疗、物理治疗及康复运动治疗等)。观察各组方法对髋部骨折患者干预效果,≥10个月随访结果评估。结果:206例髋部骨折患者中,诊断为骨质疏松症160例(77.7%),145例获得≥10个月随访,随访率90%(145/160)。综合治疗组疗效总优良率明显高于单纯骨科治疗组(74.0%,65.5%,χ2=1.327,P<0.05);住院时间明显短于单纯骨科治疗组(28.1±5.6),(42.4±4.4)d,t=9.86,P<0.01;长期卧床引起的各种并发症发生率明显少单纯骨科治疗组9%(9/96),16%(8/49),χ2=1.515,P<0.05;其他部位再次发生骨折率明显低于单纯骨科治疗组(6%,14%,χ2=2.567,P<0.01)。结论:老年髋部骨折患者在手术后?
AIM: To compare the long-term efficacy between simple orthopedic traction or operation and that combined with anti-osteoporosis in treating elderly patients with hip fracture. METHODS: Totally 206 elderly patients (84 males and 122 females) with new (within two weeks) hip fracture at 60 to 89 years old, who were hospitalized in the Department of Orthopaedics, Second Affiliated Hospital of Guangzhou Medical College and Guangzhou Sixth People' s Hospital from September 1999 to January 2004, were divided into two groups voluntarily: simple orthopedic therapy group (28 cases were treated with traditional traction only and 41 cases were treated with orthopedic operation only) and comprehensive therapy group (49 cases were treated with traction+anti-osteoporosis therapy and 88 cases were treated with operation+anti-osteoporosis therapy).Anti-osteoporosis therapy included dietary adjustment,application of western medicine, traditional Chinese medicine (TCM) therapy,physical therapy and rehabilitation exercise therapy for osteoporosis. The interventional effects of the methods in each group in treating hip fracture were observed,and the patients were followed up for no less than 10 months for evaluation of results. RESULTS: Among the 206 patients with hip fracture, 160 cases (77.7%) were diagnosed to have osteoporosis, and 145 cases were followed up for no less than 10 months,the follow-up rate was 90%(145/160).The total good rate of curative efficacy was obviously higher in the comprehensive therapy group (74.0%) than in the simple orthopedic therapy group(65.5%) (χ2=1.327,P< 0.05).The length of stay was obviously shorter in the comprehensive therapy group[(28.1±5.6) days] than in the simple orthopedic therapy group [(42.4±4.4) days](t=9.86, P< 0.01).The incidence rate of complications caused by long-term bed in the comprehensive therapy group was markedly lower than that in the simple orthopedic therapy group[16%(8/49)] (χ2=1.515, P< 0.05).The reoccurrence rate of fracture at other sites was obviously lower in the comprehensive therapy group(6%) was markedly lower than in the simple orthopedic therapy group (14%) (χ2=2.567, P< 0.01). CONCLUSION: Anti-osteoporosis therapy, which is given to elderly patients with hip fracture after operation, can improve the curative efficacy, shorten the length of stay and reduce complications in a short time, it also has the long-term effects in preventing the reoccurrence of fracture.
出处
《中国临床康复》
CSCD
北大核心
2005年第15期164-165,共2页
Chinese Journal of Clinical Rehabilitation
