摘要【目的】 探讨骨密度水平对老年脊柱骨折患者骨痛和手术预后的影响。【方法】 收集2017年7～12月在本院骨科接受手术治疗的老年(>60岁)脊柱骨折患者,采用双能X线测定骨密度,根据骨密度水平分为低水平骨密度组(T值＜1.0)和高水平骨密度组(T值≥-1.0)。两组均采用模拟疼痛评估量表(VAS)评估疼痛程度,随访记录患者的术后相关指标评估其预后状况。【结果】 低水平骨密度组在术后12 h、24 h VAS量表评分均显著高于高水平骨密度组(P<0.05),而术后48 h两组VAS量表评分比较差异无统计学意义(P>0.05);两组术后至出院的天数、总住院天数、术后并发感染及低钾血症构成比比较差异有统计学意义(P<0.05);术后12 h VAS评分与患者骨密度水平呈显著负相关(P<0.05),而术后24 h、48 h VAS评分与患者骨密度水平无显著相关性(P>0.05)。骨密度水平减低是术后骨痛程度增加的危险因素(P<0.05);此外,术后并发感染、骨折段数和椎体压缩程度也均为骨痛程度增高的危险因素(P<0.05)。【结论】 低骨密度水平可能是影响老年脊柱骨折患者骨痛水平的一个危险因素,同时低骨密度水平也可影响患者术后的预后状况。
Abstract：【Objective】 To investigate the effect of bone mineral density (BMD) on the bone pain and operative prognosis in elderly patients with spinal fracture. 【Methods】 From July to December 2017, 118 elderly patients (> 60 years old) with spine fracture who were operated in our orthopedic department were collected. The BMD was measured by dual energy X-ray. According to the BMD level, they were divided into low level BMD group (t value < 1.0) and high level BMD group (t value ≥ 1.0). The degree of pain was assessed by VAS in both groups, and the prognosis of the patients was evaluated by postoperative related indexes.【Results】 The VAS score of the low-level BMD group was significantly higher than that of the high-level BMD group (P<0.05) at 12 h and 24 h after operation, but there was no significant difference between the two groups at 48 h after operation (P>0.05); there were significant differences between the two groups in the days from operation to discharge, the total days in hospital, the complicated infection and the proportion of hypokalemia (P<0.05); 12 h after operation There was a significant negative correlation between vas and BMD (P<0.05). There was no significant correlation between vas and BMD at 24 and 48 hours after operation (P>0.05). The decrease of BMD was the risk factor for the increase of the degree of bone pain (P<0.05); in addition, the postoperative infection, the number of fracture segments and the degree of vertebral compression were also the risk factors for the increase of the degree of bone pain (P<0.05).【Conclusion】 Low BMD level may be a risk factor for the level of bone pain in the elderly patients with spinal fracture. At the same time, low BMD level may also affect the prognosis of the patients.
李浩, 李晓淼, 沈奕, 王伟力. 骨密度水平对老年脊柱骨折患者骨痛的影响及危险因素分析[J]. 医学临床研究, 2020, 37(4): 539-541.
LI Hao, LI Xiao-miao, SHEN Yi, et al. Effect of Bone Mineral Density on Bone Pain in Elderly Patients with Spinal Fracture and Analysis of Risk Factors. JOURNAL OF CLINICAL RESEARCH, 2020, 37(4): 539-541.
2020, Vol. 37 
