CAJ | 학술논문

目的评价老年股骨转子间骨折患者术后的生命质量及其影响因素,为治疗和康复方法的选择提供新的结局指标,从而指导临床。方法应用SF-36量表中文版测定2007年10月～2009年10月本院骨科收治的35例老年股骨转子间骨折患者术后的生命质量,并与当地常模进行比较。对性别、年龄、合并伤、骨折类型、并发症、功能结果等指标进行单因素分析,取其中有统计学意义的变量作多因素Logistic回归分析。结果本组患者生命质量综合评分较当地一般人群下降,差异有显著性(P<0.000),但GH,VT、RE、MH四个维度与一般人群相当(P<0.000),仅PF、RP 、BP、SF四个维度较一般人群下降(P>0.05)。单因素分析显示年龄、存在内科合并症、骨折类型及功能结果等与股骨转子间骨折术后生命质量有关,其中骨折类型和功能结果在多因素分析时最终进入Logistic回归方程。结论老年股骨转子间骨折患者术后总体生命质量较一般人群下降,但在心理、精神因素方面与一般人群无显著差异,在生理活动方面较一般人群下降并造成了职能限制。骨折类型和功能结果是影响老年股骨转子间骨折患者术后生命质量的独立危险因素,其中功能结果是最重要的可控性因素。年龄以及存在内科合并症是影响生命质量的间接因素。
목적평개노년고골전자간골절환자술후적생명질량급기영향인소,위치료화강복방법적선택제공신적결국지표,종이지도림상。방법응용SF-36량표중문판측정2007년10월～2009년10월본원골과수치적35례노년고골전자간골절환자술후적생명질량,병여당지상모진행비교。대성별、년령、합병상、골절류형、병발증、공능결과등지표진행단인소분석,취기중유통계학의의적변량작다인소Logistic회귀분석。결과본조환자생명질량종합평분교당지일반인군하강,차이유현저성(P<0.000),단GH,VT、RE、MH사개유도여일반인군상당(P<0.000),부PF、RP 、BP、SF사개유도교일반인군하강(P>0.05)。단인소분석현시년령、존재내과합병증、골절류형급공능결과등여고골전자간골절술후생명질량유관,기중골절류형화공능결과재다인소분석시최종진입Logistic회귀방정。결론노년고골전자간골절환자술후총체생명질량교일반인군하강,단재심리、정신인소방면여일반인군무현저차이,재생리활동방면교일반인군하강병조성료직능한제。골절류형화공능결과시영향노년고골전자간골절환자술후생명질량적독립위험인소,기중공능결과시최중요적가공성인소。년령이급존재내과합병증시영향생명질량적간접인소。
Objective To evaluate the quality of life of the patients suffered intertrochanteric fractures treated with the technique of minimally invasive plate osteosynthesis (MIPO) using the locking compress plate(LCP), and analyze its influential factors. Methods Self-management method was applied to filling the Chinese version SF-36 to assess the quality of life of 35 patients with intertrochanteric fractures treated with the technique of minimally invasive plate osteosynthesis (MIPO) using the locking compress plate(LCP). Firstly, univariate analysis was used in 12 clinical variables. Then, multivariate Logistic regression analysis was used in the selected variables. Results To compare with general people in Sichuan province, levels of the PF, RP, BP and SF were below local population norms matched for age and sex, and levels of the GH, VT, RE and MH were comparable to the local population norms. The general quality of life was below the local population norm. The age of the patient, fracture type, the presence of internal complications, and functional outcome were selected through single factoranalysis. By Logistic regression analysis, fracture type and functional outcome were in the Logistic regression equation. Conclusion The quality of life of the patients suffered intertrochanteric fractures treated with the technique of minimally invasive plate osteosynthesis (MIPO) is poorer than generallocal people. Associated fracture type and sub-optimal outcome were risk factors independently associated with a poorquality of life. The age of the patient and the presence of internal complications were factors which were not directly associated with a poor quality of life.