辽宁省两所医院老年骨质疏松性骨折患者再骨折预防现状的横断面研究

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目的:了解辽宁省大连市与沈阳市两所三甲医院老年骨质疏松性骨折患者诊疗情况,为大连及沈阳地区骨质疏松性骨折防治提供科学依据。方法:筛选2015年1—12月大连医科大学附属第二医院和辽宁省人民医院60岁以上老年骨质疏松性骨折住院患者为研究对象,对其人群基本特征、骨折发生部位、发生骨折部位数目、骨折次数、骨质疏松诊疗以及骨质疏松骨折二级预防情况进行综合分析。结果:两所医院60岁以上骨质疏松性骨折人群中女性多于男性(n P = 0.00)。骨折好发部位顺次为髋部、脊柱、尺桡骨远端、肱骨近端,依次为38.26%(295/771)、34.63%(267/771)、9.34%(72/771)、5.71%(44/771)。发生再次骨折为10.89%(84/771)。老年骨质疏松性骨折患者在院诊断骨质疏松症为13.88%(107/771);在院期间针对骨质疏松药物治疗为24.64%(190/771);出院医嘱骨质疏松药物治疗为18.81%(145/771)。仅0.65%(5/771)的老年骨质疏松性骨折患者在院期间及出院医嘱中既诊断骨质疏松症又给予基础治疗(维生素Dn 3及钙剂)及抗骨质疏松治疗。n 结论:大连及沈阳地区两所三甲医院老年骨质疏松性骨折患者在院骨质疏松症的诊断构成比、药物治疗构成比及出院医嘱骨质疏松药物治疗构成比普遍偏低,老年骨质疏松性骨折二级预防工作普遍没有被重视,防治形势严峻。“,”Objective:To study the diagnosis and treatment of osteoporotic fractures in the elderly in two third Grade A hospitals in Shenyang and Dalian, and to provide scientific basis for prevention and treatment of osteoporotic fractures in Dalian and Shenyang.Methods:Patients of osteoporotic fractures over 60 years old from January 2015 to December 2015 in the Second Hospital of Dalian Medical University and the People′s Hospital of Liaoning Province were chosen, and the basic characteristics, fracture site, the number of fracture site, diagnosis treatment and secondary prevention of osteoporosis fractures of them were analyzed.Results:Among the patients of osteoporotic fractures over 60 years old in the hospitals of Shenyang and Dalian, women were more than men (n P = 0.00). The predilection sites of elderly osteoporotic fractures in two hospitals were both followed by the hip, spine, ulnar and radial distal, proximal humerus. The rates respectively were 38.26%(295/771), 34.63% (267/771), 9.34%(72/771), 5.71%(44/771). The rate of fracture-again was 10.89%(84/771). The rates of in-hospital diagnosis, in-hospital treatment and treatment of discharged medical advice among osteoporosis were 13.88%(107/771), 24.64%(190/771) and 18.81%(145/771). There were 0.65% (5/771) patients who had diagnosis of osteoporosis, basic osteoporosis treatment (vitamin Dn 3 and calcium) and anti-osteoporosis treatment in both in-hospital and discharged medical advice.n Conclusions:The rates of in-hospital diagnosis, in-hospital osteoporosis treatment and anti-osteoporosis treatment in discharged medical advice are both very low in the two third Grade A hospitals. The secondary prevention of osteoporosis fractures in the elderly has not been taken attention, and the situation of prevention and treatment are serious.
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