多脏器疾病老年人骨折愈合及骨折病防治.docVIP

多脏器疾病老年人骨折愈合及骨折病防治 　 作者：苟三怀 杨立利 葛亮 刘岩 欧阳跃平 韩庆林 王琪 席焱海 　　[摘要]目的 探讨如何提高70岁以上多脏器疾病（衰退）老年人骨折愈合问题及骨折病防治的措施和方法。方法 1、老年人骨折后仔细了解骨折前疾病史并积极预防和治疗，对患有多脏器疾病的如严重的心血管疾病、呼吸系统疾病等由专科协同治疗，2、早期有效的手术治疗方法，3、鼓励早期肢体运动，4、预防骨质疏松、关节退变、肌肉萎缩等骨折病。 结果 本组随访258例，随访时间1～5年，平均随访时间3.8年。死亡8例（3.10%），恢复自主生活能力199例(77.13%)；部分恢复生活能力32例（12.40%）；失去生活能力19例（7.36%）。骨折愈合情况；除死亡8例外，250例进行定期随访；8～10月骨折愈合225例，10个月以上骨折愈合25例；（其中包括慢性感染影响骨折愈合3例），内固定松动6例，内固定断裂4例。 结论 对患有多脏器衰退老年人骨折后在内科疾病的管理监护下，早期进行手术治疗，减少老年人骨折后并发症，积极进行肢体功能锻炼，能有效的提高骨折愈合和老年人日后生活质量。 　　[关键词] 老年人；多脏器疾病；骨折愈合；生活质量 [Abstract] Objective To implore the methods improving fracture healing in patients older than 70 years and the strategies preventing and treating fracture diseases. Methods Firstly, for eldly patients the history of diseases were reviewed and then active treatments were carried out. Those with serious disturbances in cardiovascular and respiratory system were treated with the cooperation of special departments. Secondly, early and appropriate operations were applied. Third, early functional movements after operation were encouraged. In addtion, positive measures were taken to prevent the fracture diseases, such as osteoporosis, joint degeneration and muscle atrophy, etc. Results 258 cases were followed up for 1 to 5 years (mean 3.8 yrs ) , with 8 death（3.10%）, 199 complete recovery (77.13%)；32 partially recovery（12.40%）；19 inabilities（7.36%）. For the 250 patients alive, 225 got bone healing in 8 to 10 months, 25 got bone healing in more than 10 months ( 3 chronic infection), 6 cases were found internal fixation loosening，4 cases were found internal fixation failure. Conclusion Positive treatments of basic diseases, early operation and active movement of the extremities could reduce the complications of fracture in eldly people, as well as improve the bone healing and life quality. 　　[Key words] eldly people；multiple organ diseases；fracture healing；life quality 　　老年人骨折后由于骨质疏松症、骨折区骨质吸收、肌肉萎缩、关节活动障碍等并发症而引起的骨折延期愈合或不愈合被称为“老年性骨折病”。老年人一旦骨折，由于创伤后应激反应、营养低下、长期卧床等因素的