上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

老年外伤性脊柱骨折的临床特点及预防分析

陈国强，方秀统，俞 猛   

  1. 首都医科大学附属北京世纪坛医院骨科， 北京 100038
  • 出版日期:2014-10-28 发布日期:2014-10-28
  • 作者简介:陈国强（1965—）， 男， 副主任医师， 硕士; 电子信箱: chenguoqiang@medmail.com.cn。
  • 基金资助:

    教育部留学归国人员科研启动基金项目（2013-1792）

Analysis of clinical characteristics and prevention of traumatic spinal fracture of elderly patients

CHEN Guo-qiang, FANG Xiu-tong, YU Meng   

  1. Department of Orthopaedics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Online:2014-10-28 Published:2014-10-28
  • Supported by:

    Scientific Research Foundation of Ministry of Education for the Returned Overseas Chinese，2013-1792

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摘要：

目的 探讨老年外伤性脊柱骨折的临床特点，为完善老年性脊柱骨折患者预防措施及提高治疗效果提供依据。方法 对168例老年外伤性脊柱骨折患者的年龄与性别分布情况、骨折原因、损伤节段及骨质疏松等级等临床资料进行回顾性分析。结果 年龄分布主要集中在62～69岁，占64.3%（108/168）；摔伤是导致脊柱骨折的主要原因，占51.8%（87/168），且女性比例较高（P<0.05），而男性高处坠落伤及重物砸伤比例较高（P<0.05）。285个损伤节段中，胸椎及腰椎占81.1% (231/285)，其中胸腰段占54.7%（156/285）。男性患者颈椎骨折比例显著高于女性（P<0.05）。女性患者胸椎及胸腰段骨折比例显著高于男性患者（P<0.05）。随着年龄的增长，骨小梁的级数逐渐降低（P<0.05）。同年龄患者中，老年女性骨小梁的级数明显低于老年男性（P<0.05）。结论 老年外伤性脊柱骨折的致伤原因及骨折损伤节段具有明显的性别差异，且均伴有不同程度的骨质疏松，应根据老年人性别差异与其自身特点对其外伤性脊柱骨折进行预防。

关键词: 老年人, 脊柱骨折, 性别差异, 骨质疏松, 预防

Abstract:

Objective To investigate the clinical characteristics of traumatic spinal fractures of the elderly and to provide evidences for improving preventive measures and treatment for elderly patients with spinal fractures. Methods One hundred and sixty eight elderly patients with traumatic spinal fractures were selected. Their clinical data, such as distributions of age and sex, causes of fractures, fractured levels, and osteoporosis levels, etc. were retrospectively analyzed. Results Most patients were 62 to 69 years old, accounting for 64.3% (108/168) of all patients. Falling was the main cause of traumatic spinal fracture, accounting for 51.8% (87/168), and female patients were more than male patients (P<0.05). The rate of falling from high places and hitting by heavy objects of male patients was higher than that of female patients (P<0.05). Among 285 vertebral body fractures, thoracic and lumbar vertebral body fractures accounted for 81.1% (231/285), in which thoracolumbar segment fractures accounted for 54.7% (156/285). The rate of cervical spinal fractures of male patients was significantly higher than that of female patients (P<0.05). The rate of thoracic and thoracolumbar spinal fractures of female patients was significantly higher than that of male patients (P<0.05). The grade of trabecular bone of male and female patients decreased progressively with the age (P<0.05). Among patients with the same age, the grade of trabecular bone of female patients was significantly lower than that of male patients (P<0.05). Conclusion Causes of traumatic spinal fractures and the segments of spinal fractures between elderly male patients and elderly female patients are significantly different. All patients have different degrees of osteoporosis. Prevention of traumatic spinal fractures should be carried out according to the gender difference and their own characteristics.

Key words: elderly, spinal fractures, sex differences, osteoporosis, prevention