老年骨质疏松症患者髋关节置换术后预后及相关因素分析
Analysis of the prognosis and related factors of hip replacement in elderly patients with osteoporosis
  
DOI:10.3969/j.issn.1006-7108.2019.08.005
中文关键词:  骨质疏松  髋关节置换术  预后  影响因素
英文关键词:osteoporosis  hip replacement  prognosis  influencing factors
基金项目:国家自然科学基金资助委员会地区科学基金项目(81560799);广西自然科学基金(2010GXNSFA013223);广西卫生厅重点课题(S201419-05)
作者单位
朱江龙 陈跃平* 董盼锋 陈涛 容向宾 章晓云 冯洋 卓映宏 广西中医药大学附属瑞康医院创伤骨科与手外科广西 南宁 530011 
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中文摘要:
      目的 分析老年骨质疏松症患者髋关节置换术后预后情况及相关因素,为改善老年骨质疏松症患者预后提供依据。方法 依据预后将本院2015年1月至2017年12月行髋关节置换术的154例老年骨质疏松症患者分为观察组(预后不良)与对照组(预后良好)。回顾性比较两组患者相关资料,通过Logistic多因素回归分析影响患者预后的因素。结果 术后6个月预后良好121例,预后良好率为78.57%;在体质量指数(BMI,27~35 kg/m2)、康复介入时间(7 d)、术后并发症所占比例方面,观察组均显著高于对照组,术后口服维生素D比例显著低于对照组(P<0.05),观察组入院时骨密度、血清PTH、BLAP水平分别为(–3.04±0.36)、(30.65±3.98)μg/mL、(42.13±5.27)μg/L,较对照组的(–2.73±0.20)、(25.76±3.32)μg/mL、(34.95±4.32)μg/L比较差异有统计学意义(P<0.05);Logistic回归分析显示高体质量指数(BMI)、低骨密度为髋关节置换术后预后不良的独立危险因素,而康复介入时间为保护因子。结论 老年骨质疏松症患者髋关节置换术后预后影响因素较多,其独立危险因素包括高BMI、低骨密度,术后早期康复训练可改善预后。
英文摘要:
      Objective To analyze the prognosis and related factors of hip replacement in elderly patients with osteoporosis, and to provide evidence for improving the prognosis of elderly patients with osteoporosis. Methods According to the prognosis, 154 cases of elderly patients with osteoporosis who underwent hip replacement from January 2015 to December 2017 were divided into observation group (poor prognosis) and control group (good prognosis). The related data of the two groups were compared retrospectively, and the factors affecting the prognosis were analyzed using logistic multivariate regression. Results The prognosis was good in 121 cases at 6 months after operation with a good prognosis rate of 78.57%. The proportion of BMI of 27 - 35kg/m2, rehabilitation intervention time (7 d),and postoperative complications in the observation group were significantly higher than those in the control group , postoperative use of oral vitamin D were significantly lower than that in the control group (P<0.05). The bone mineral density and serum levels of PTH and BLAP in the observation group were (-3.04±0.36), (30.65±3.98) μg/mL, and(42.13±5.27)μg/L, respectively. The above values were (–2.73±0.20), (25.76±3.32) μg/mL, and(34.95±4.32)μg/L, respectively, in the control group (P<0.05). Logistic regression analysis showed that high BMI and low bone mineral density were independent risk factors for poor prognosis after hip replacement, and rehabilitation intervention time was a protective factor. Conclusion There are many influencing factors for the prognosis of hip replacement in elderly patients with osteoporosis. The independent risk factors include high BMI and low bone mineral density. Early postoperative rehabilitation training can improve prognosis.
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