CAJ | 학술논문

目的调查京津唐地区成人肱骨近端骨折流行学特征. 方法多中心回顾性分析2010年1月至2011年12月京津唐地区8所医院诊治的成人新鲜骨折患者资料,筛选肱骨近端骨折纳入本研究.定义北京地区医院患者资料为A组,天津地区医院患者资料为B组,唐山地区医院患者资料为C组,统计患者年龄、性别、骨折AO/OTA分型等数据,分析影响骨折严重程度的因素. 结果共收治1 485例肱骨近端骨折患者,平均年龄为58.47岁,其中50～ 79岁年龄段患者最多(59.06％).男568例,女917例,男女比为0.62:1.11-A型、11-B型和11-C型骨折分别占67.47％、20.34％和12.19％.11-A1、11-A2、11-A3和11-B1型骨折最常见,共占80.00％.A、B、C组男女比分别为0.05∶1、0.55∶1和1.01∶1,差异有统计学意义(x2 =29.410,P＜0.001),A、B、C组骨折年龄构成差异有统计学意义(x2=73.160,P＜0.001),3组患者AO/OTA分型构成差异有统计学意义(x2=74.524,P＜0.001).年龄、性别、地区和季节是骨折严重程度的独立影响因素:随年龄增长更易发生严重骨折[OR=1.015,95％ CI(1.009,1.021),P＜0.001],男性比女性发生严重骨折风险低[OR=0.738,95％CI(0.599,0.909),P＜0.001],北京[OR=0.244,95％CI(0.190,0.313),P＜0.001]和天津[OR =0.281,95％CI(0.217,0.362),P＜0.001]患者比唐山患者发生严重成人肱骨近端骨折风险低,夏季比冬季更易发生严重骨折[OR =1.366,95％ CI(1.088,1.717),P=0.007].结论成人肱骨近端骨折以女性患者为主,50 ～79岁患者最多,随骨折严重程度升高骨折例数减少.年龄、性别、患者来源地区和季节均为影响骨折复杂程度的独立危险因素,对骨折严重程度的预测提供了科学参考.
목적 조사경진당지구성인굉골근단골절류행학특정. 방법 다중심회고성분석2010년1월지2011년12월경진당지구8소의원진치적성인신선골절환자자료,사선굉골근단골절납입본연구.정의북경지구의원환자자료위A조,천진지구의원환자자료위B조,당산지구의원환자자료위C조,통계환자년령、성별、골절AO/OTA분형등수거,분석영향골절엄중정도적인소. 결과 공수치1 485례굉골근단골절환자,평균년령위58.47세,기중50～ 79세년령단환자최다(59.06％).남568례,녀917례,남녀비위0.62:1.11-A형、11-B형화11-C형골절분별점67.47％、20.34％화12.19％.11-A1、11-A2、11-A3화11-B1형골절최상견,공점80.00％.A、B、C조남녀비분별위0.05∶1、0.55∶1화1.01∶1,차이유통계학의의(x2 =29.410,P＜0.001),A、B、C조골절년령구성차이유통계학의의(x2=73.160,P＜0.001),3조환자AO/OTA분형구성차이유통계학의의(x2=74.524,P＜0.001).년령、성별、지구화계절시골절엄중정도적독립영향인소:수년령증장경역발생엄중골절[OR=1.015,95％ CI(1.009,1.021),P＜0.001],남성비녀성발생엄중골절풍험저[OR=0.738,95％CI(0.599,0.909),P＜0.001],북경[OR=0.244,95％CI(0.190,0.313),P＜0.001]화천진[OR =0.281,95％CI(0.217,0.362),P＜0.001]환자비당산환자발생엄중성인굉골근단골절풍험저,하계비동계경역발생엄중골절[OR =1.366,95％ CI(1.088,1.717),P=0.007].결론 성인굉골근단골절이녀성환자위주,50 ～79세환자최다,수골절엄중정도승고골절례수감소.년령、성별、환자래원지구화계절균위영향골절복잡정도적독립위험인소,대골절엄중정도적예측제공료과학삼고.
Objective To investigate the epidemiological features of adult fractures of the proximal humerus in Beijing,Tianjin and Tangshan.Methods A multicenter epidemiological survey was performed on the adult patients with proximal humeral fracture who had sought medical treatment at 8 hospitals in Beijing,Tianjin,and Tangshan between January 2010 and December 2011.The patients from the Beijing hospitals were assigned into Group A,those from Tianjin hospitals into Group B,and those from Tangshan hospitals into Group C.Age,gender and AO/OTA classification of the patients were documented to analyze their impacts on the fracture severity.Ordinal multivariable logistic analysis was used to analyze the independent risk factors for the fractures.Results Altogether 1,485 adult fractures of the proximal humerus were included in the present survey.They involved 568 men and 917 women,with an average age of 58.47 years.The male to female ratio in the whole survey population was 0.62:1.The majority of the patients (59.06％) were between 50 and 79 years of age.The proportions of types 1 1-A,11-B and 11-C were respectively 67.47％,20.34％ and 12.19％.The most common fracture types were 11-A1,11-A2,11-A3 and 11-B1,accounted for 80.00％ of all the proximal humeral fractures.The male to female ratios in Beijing,Tianjin,and Tangshan were 0.50:1,0.55:1 and 1.01:1,showing significant differences between groups A,B and C (x2 =29.410,P ＜ 0.001).Significant differences also existed between the 3 groups in age distribution(x2 =73.160,P ＜ 0.001) and distribution of AO/OTA fracture types(x2 =74.524,P ＜ 0.001).Age,gender,region and season were independent risk factors for the fracture.Higher age was associated with a more serve fracture [OR =1.015;95％ CI (1.009,1.021),P ＜ 0.001];men had a lower fracture risk than women [OR=0.738;95％ CI (0.599,0.909),P ＜0.001];Beijing [0R=0.244,95％CI (0.190,0.313),P＜ 0.001] and Tianjin [OR =0.281,95％ CI (0.217,0.362),P＜ 0.001] had a lower risk of severe fracture of the proximal humerus than Tangshan;summer witnessed more severe fractures than winter [OR=1.366,95％ CI (1.088,1.717),P =0.007].Conclusions The adult fractures of the proximal humerus in Beiji ng,Tianjin,and Tangshan from 2010 through 2011 were more common in women than in men.The majority of the patients were between 50 to 79 years of age.The cases of the fracture decreased with the severity.Age,gender,region and season were independent risk factors which can be used to predict the severity of adult fracture of the proximal humerus.