海南医科大学学报

目的:探讨高龄老人四肢骨折后不同治疗措施对短期生存率的影响。方法:收集我院2005年1月～2010年8月住院治疗的75岁以上老年人四肢骨折患者658例,分别采取手术、无创外固定治疗、止痛制动3种治疗措施,对3组病例伤后第12个月的生存率分为上、下肢骨折分别进行统计。结果:随访骨折后12个月时仍存活635例。在上肢骨折组内的生存数和生存率分别是:手术组139例(97.8%),无创外固定组7例(77.8%),止痛制动组9例(100.0%),组间无统计学差异(P>0.05)。在下肢骨折组内的生存数和生存率分别是:手术组435例(97.1%),无创外固定组34例(89.5%),止痛制动组11例(91.7%),组间有统计学差异(P<0.05)。结论:上肢骨折的治疗措施可能会对肢体功能造成影响,但对伤后1年时的生存率无影响;下肢骨折手术治疗可以提高伤后1年时的生存率,对于不能手术的高龄老人仅止痛制动治疗生存率高于长期卧床行牵引或石膏固定治疗者。

Objective: To investigate influence of fracture treatments on elder patients′ short term survival rate.Methods:A total of 658 patients older than 75 years old with limb fractures admitted from January 2005 to August 2010 were selected.They were randomly divided into three groups.Group 1 was treated with surgery;group 2 was treated with non-invasive external fixation,group 3 was treated with pain killer and limited position.Survival rate after 12 months were observed with KruskalWallis Test according to fractures occurred in upper limbs or lower limbs.Results:According to12 months follow-up,635 patients were still alive.For those with upper limb fractures,there were 139 cases(97.8%),7(77.8%) and 9 patients(100%) alive in group 1,2 and 3,showing no significant difference among the three groups(P>0.05).For patients with lower limb fractures,there were 435 cases(97.1%),34(89.5%) and 11(91.7%) alive from group 1,2,3 respectively,showing significant difference among the three groups(P<0.01).Conclusions: Fractures in upper limbs may affect function of the involved limb,but have no effect on 1 year survival rate,while surgery for lower limb fractures can raise 1 year survival rate.For elder patients that can not tolerate surgery,treatment of restricted position is more useful in prolonging survival rate than treatment of traction or plasters splintage.