中华关节外科杂志(电子版)
中華關節外科雜誌(電子版)
중화관절외과잡지(전자판)
CHINESE JOURNAL OF JOINT SURGERY(ELECTRONIC VERSION)
2009年
4期
449-453
,共5页
袁忠治%吴镇权%刘刚%李震%李国新%温健%杨昀焯%汤晨逢%李继云
袁忠治%吳鎮權%劉剛%李震%李國新%溫健%楊昀焯%湯晨逢%李繼雲
원충치%오진권%류강%리진%리국신%온건%양윤작%탕신봉%리계운
老年人%髋骨折%手术后并发症%骨质疏松
老年人%髖骨摺%手術後併髮癥%骨質疏鬆
노년인%관골절%수술후병발증%골질소송
Aged%Hip fractures%Postoperative complications%Osteoporosis
目的 探讨老年髋部骨折术后无应用抗骨质疏松药物治疗患者的骨质变化.方法 入选本研究的患者共12例,平均年龄77.6岁,髋部骨折术后平均8.6年.全部患者接受对骨质疏松症认知水平询问;双能X线吸收骨密度仪(DXA)测定5例股骨近端和7例腰椎骨密度,并与在门诊经规范骨质疏松治疗1年以上随机选取的骨质疏松症患者(男3例,女9例,平均年龄74岁)骨密度比较,两组相应部位数值进行t检验;影像学检查包括拍摄骨盆正位片和腰椎X线片,部分患者作腕部X线片或腰椎MRI检查. 结果 患者对骨质疏松症认知水平低(16%).腰2、3椎体和股骨近端骨密度均降低,以股骨近端更为明显(P<0.05).6例人工髋关节假体柄松动,3例髋臼磨损,2例动力髋钢板螺钉和1例股骨近端髓内钉松动伴移位,所有患者腰椎椎体骨小梁稀疏,共有9例椎体呈压缩性骨折,16例椎体呈明显"双凹"征,3例桡骨远端骨小梁稀疏.结论 老年髋部骨折术后如无进行抗骨质疏松药物治疗,骨质可能会变得更加脆弱.
目的 探討老年髖部骨摺術後無應用抗骨質疏鬆藥物治療患者的骨質變化.方法 入選本研究的患者共12例,平均年齡77.6歲,髖部骨摺術後平均8.6年.全部患者接受對骨質疏鬆癥認知水平詢問;雙能X線吸收骨密度儀(DXA)測定5例股骨近耑和7例腰椎骨密度,併與在門診經規範骨質疏鬆治療1年以上隨機選取的骨質疏鬆癥患者(男3例,女9例,平均年齡74歲)骨密度比較,兩組相應部位數值進行t檢驗;影像學檢查包括拍攝骨盆正位片和腰椎X線片,部分患者作腕部X線片或腰椎MRI檢查. 結果 患者對骨質疏鬆癥認知水平低(16%).腰2、3椎體和股骨近耑骨密度均降低,以股骨近耑更為明顯(P<0.05).6例人工髖關節假體柄鬆動,3例髖臼磨損,2例動力髖鋼闆螺釘和1例股骨近耑髓內釘鬆動伴移位,所有患者腰椎椎體骨小樑稀疏,共有9例椎體呈壓縮性骨摺,16例椎體呈明顯"雙凹"徵,3例橈骨遠耑骨小樑稀疏.結論 老年髖部骨摺術後如無進行抗骨質疏鬆藥物治療,骨質可能會變得更加脆弱.
목적 탐토노년관부골절술후무응용항골질소송약물치료환자적골질변화.방법 입선본연구적환자공12례,평균년령77.6세,관부골절술후평균8.6년.전부환자접수대골질소송증인지수평순문;쌍능X선흡수골밀도의(DXA)측정5례고골근단화7례요추골밀도,병여재문진경규범골질소송치료1년이상수궤선취적골질소송증환자(남3례,녀9례,평균년령74세)골밀도비교,량조상응부위수치진행t검험;영상학검사포괄박섭골분정위편화요추X선편,부분환자작완부X선편혹요추MRI검사. 결과 환자대골질소송증인지수평저(16%).요2、3추체화고골근단골밀도균강저,이고골근단경위명현(P<0.05).6례인공관관절가체병송동,3례관구마손,2례동력관강판라정화1례고골근단수내정송동반이위,소유환자요추추체골소량희소,공유9례추체정압축성골절,16례추체정명현"쌍요"정,3례뇨골원단골소량희소.결론 노년관부골절술후여무진행항골질소송약물치료,골질가능회변득경가취약.
Objective To study the bone character changes in the elders without anti-osteoporosic medicine treatment after hip fracture operations.Methods 12 cases of elder in/out-patients with average age of 77.6 years were selected, who never took any anti-osteoporosic medicines after their hip fractures operations for average 8.6 years. All patients were investigated in general knowledge about osteoporosis. The Dual energy X-ray absorptiometry(DXA) bone density was measured in proximal femurs for 5 cases and lumbar vertebrae for 7 cases, and compared by t-test to control group(osteoporosis out-patients randomly selected who have been treated normatively for more than one year). Results The degree of patients' general knowledge on osteoporosis was poor(16%). The DXA bone density of proximal femurs and second, third lumbar vertebrae was decreased, especially in the proximal femurs(P<0.05). 6 stems of artificial hip joints were loosening, 3 acetabulums were worn out, 2 DHS and 1 PFN were loosening with displacement. Conclusions The bone characters may become more frangible in the elders without anti-osteoporosic medicine treatment after hip fracture.