The Diagnosis And Treatment Of Osteoporotic Fracture Of A Third-grade Hospital In Kunming

Objectives:A preliminary analysis of the diagnosis and treatment of osteoporotic fractures in a top-three hospital in Kunming;2.To investigate the effect of basic anti-osteoporosis treatment on the rate of recurrence after percutaneous kyphoplasty(PKP).This will further provide evidence for the diagnosis and treatment of secondary osteoporosis in elderly patients with osteoporotic fractures in the region.Methods:The first part Retrospectively analyzed the clinical data of 712 cases of osteoporotic fracture patients over 55 years of age admitted from January 2015 to December 2017 in a hospital in Kunming.The basic situation(age,gender,number of fractures in each age group),clinical data(whether using dual-energy X-ray absorptiometry to determine bone mineral density,fracture site,whether surgical treatment,fracture frequency),discharge diagnosis is diagnosed as bone Osteoporosis and anti-osteoporosis treatment programs during hospitalization and after discharge were statistically analyzedThe second part Screened from the first part of the research object to meet the dual energy X-ray Absorptiometry(DXA)to determine the bone mineral density value and T<-2.5SD,osteoporotic thoracolumbar fractures and fractures after passing through Patients with kyphoplasty(PKP),postoperative anti-osteoporosis(calcium carbonate D3 and calcitriol)or non-osteoporotic treatment,based on whether or not anti-osteoporosis treatment For the two groups,the experimental group:Percutaneous kyphoplasty(PKP)under local anesthesia and calcium carbonate D3 and calcitriol anti-osteoporosis for the whole course of operation,n=38 cases;control group:under local anesthesia Percutaneous kyphoplasty(PKP)was not performed after surgery,and n=25 cases.The clinical data of two groups were statistically analyzed,such as gender,age,preoperative bone mineral density(T),and fracture(single vertebral fracture or multiple vertebral fractures).SPSS 23.0 software was used to analyze the differences between the indexes P>0.05.General data are not statistically significant and comparable.The rate of recurrence of fractures in the two groups within one year after treatment was calculated and analyzed by SPSS 23.0 software.The measurement data were analyzed by t-test.The count data were analyzed by x2 test.If P>0.05,the difference was not statistically significant.If P<0.05,there were differences.Statistically significant,the association between anti-osteoporosis treatment and postoperative recurrence fractures was analyzed.Results:1.Of the 712 cases of osteoporotic fracture patients over the age of 55 in a top-three hospital in Kunming,537 were females,with an average age of(74.35 ±8.45)years and 175 males,with an average age of(76.20 ±9.08)years old,including 55-65 years old.111 patients(15.6%)were aged;225 patients(31.6%)were 65-75 years old;284 patients(39.9%)were 75-85 years old;88 patients were 85-95 years old;In the case(12.4%),4 patients(0.5%)were over 95 years of age.Among elderly patients with osteoporotic fractures in Kunming area,there are more female patients than male patients,and the majority are between the ages of 65 and 85.2.The most common sites of osteoporotic osteoporotic fractures in a seniorhospital in Kunming are 325 cases(45.6%)of hips,223 cases(31.3%)of spine,51 cases of proximal humerus(7.2%),and 25 cases of distal humerus(3.5 cases).%),other parts of 88 cases(12.4%),542 cases of single site fracture(76.1%),multi-site fracture in 170 cases(23.9%).There were 29 cases(4.1%)of postoperative fractures 3.Among the elderly patients with osteoporotic fractures in a top-rankedhospital in Kunming,366(51.4%)were diagnosed with osteoporosis,80(11.2%)were diagnosed with osteoporosis by DXA,and 286(1)were osteoporotic.40.2%),601 cases(84.4%)were treated with surgery,and 21 cases(2.9%)were treated with anti-osteolysis during the hospital period,of which 15 cases(2.1%)were treated with calcium carbonate D3 + calcitriol.Four cases(0.6%)of zoledronic acid anti-osteoporosis were given,and two cases(0.3%)of calcium carbonate D3 +calcitriol + alendronate sodium anti-osteolysis were given;109 anti-osteoporosis patients were given after discharge.Cases(15.3%),of which 44 cases(6.2%)were given calcium carbonate D3 and calcitriol anti-osteoporosis,3 cases(0.4%)given calcium carbonate D3 anti-osteoporosis,given zoledronic acid anti-osteosome In 4 patients(0.6%),2 patients(0.3%)were given calcium carbonate D3 + calcitriol +alendronate sodium anti-osteophyte,and 56 patients(7.9%)were specifically unresectable bone fractures.Regardless of whether it was in the hospital or discharged,the combination of anti-osteoporosis therapy was used in 2 patients(0.3%).This hospital only pays attention to surgical treatment for patients with osteoporotic fractures,and the diagnostic rate and standardized treatment rate of osteoporosis are low.4.In patients with severe osteoporotic thoracolumbar fractures,there were 38 patients(6 males and 32 females)in the experimental group,mean age(72.74 ± 6.52)years old,bone mineral density T value(-3.87 ± 0.79)SD,and single vertebral fracture 22 Cases,multiple vertebral fractures in 16 cases,control group in 25 cases(male 9 cases,female 16 cases),mean age(72.60 ± 6.62)years,bone mineral density T value(-3.85 ± 0.71)SD,11 cases of single vertebral fractures There were 14 cases of multiple vertebral fractures.There was no significant difference in gender,age,bone mineral density(T),and fracture(single or multiple vertebral fractures)between the two groups(all P>0.05).The rate of recurrence of fracture within one year was 36.0%in the control group and 13.2%in the experimental group.There was a statistically significant difference between the two groups(P=0.033).Conclusion(s):1.surgeons only pay attention to local surgical treatment of patients with osteoporotic fractures,osteoporosis diagnosis rate and standardized anti-bone osteolysis treatment rate to be improved.2.for patients with severe osteoporotic fractures that use basic anti-osteolysis drugs can also reduce the rate of recurrence of fractures,but still need to jointly suppress bone resorption drugs or bone formation drugs,to minimize the patients with osteoporosis Fracture recurrence rate and improve the quality of life.