49例老年髋部骨折患者的手术治疗及预后评估研究

目的探讨老年髋部骨折患者的手术治疗效果及预后情况。方法选择我院2017年3月～2018年9月收治的98例患者随机分为观察组(n=49)和对照组(n=49)。对照组患者给予常规保守牵引治疗,观察组给予手术治疗。观察比较两组临床疗效、髋关节功能Harris评分及术后并发症发生情况。结果观察组优良率为89.80%高于对照组的79.59%,但差异无统计学意义(χ2=1.968,P=0.161);两组疗效整体比较,差异有统计学意义(Z=-6.928,P=0.000)。治疗后,两组Harris评分与治疗前比较均显著升高,差异有统计学意义(t=-18.663,P=0.000; t=-15.682,P=0.000);且治疗后观察组Harris评分(88.47±15.84)分显著高于对照组(81.36±12.56)分,差异有统计学意义(t=2.462,P=0.016)。观察组术后并发症发生率4.08%显著低于对照组的16.33%,差异有统计学意义(χ2=4.009,P=0.045)。结论手术治疗老年髋部骨折临床疗效显著,可有效改善患者髋关节功能,减少并发症,提高患者生活自理能力及生活质量,值得推广应用。     

Patients with hip fracture: Experiences of participation in care

Health care staff are obliged to help patients participate in their care. Previous research has shown that information and relationships with staff are important factors for patients to feel involved. The aim of the study was to describe patients’ experiences of participation during hospitalization for hip fracture. Eleven patients being treated for hip fracture were included and data were collected using interviews. Analysis of the data was carried out through qualitative content analysis. The results illustrate that the experiences of participation are governed by the patient’s personal circumstances, needs and wishes and are affected by how responsive the staff are to these. Patients’ experience of participation is also affected by having to adapt to the health care organization and structure. To pursue individualized care, staff need to start from patient preferences and it is a challenge to adapt care to both the individual and the organization. By paying attention to patient preferences, the staff have a greater opportunity to implement changes in health care that will benefit a large patient population. This can lead to patients gaining better functional capacity and quality of life.     

The Added Value of SARC-F to Prescreening Using FRAX for Hip Fracture Prevention in Older Community Adults

Objectives

To examine the potential added value of a simple 5-item questionnaire for sarcopenia screening (SARC-F) to the Fracture Risk Assessment Tool (FRAX) for hip fracture risk prediction, in order to identify at-risk older adults for screening with dual-energy x-ray absorptiometry (DXA).

血清同型半胱氨酸与头颈部动脉粥样硬化的关系研究

目的 探讨血清同型半胱氨酸（HCY）与头颈部动脉粥样硬化关系。方法 选择2016年1月至2016年12月合肥市第二人民医院行头颈部CT血管造影术（CTA）明确有动脉粥样硬化病变患者119例，根据头颈部动脉CTA结果，将轻度及轻度以上狭窄的106例患者纳为试验组，将无动脉狭窄的13例患者纳为对照组，比较两组患者的血清HCY水平。再根据头颈部动脉狭窄程度，分为轻度狭窄组（28例）、中度狭窄组（29例）与重度狭窄组（49例），比较3组患者血清HCY水平。结果 试验组患者血清HCY水平为（17.76±15.14）μmol/L，对照组为（10.95±2.73）μmol/L，两组差异有统计学意义（P<0.05）。轻度狭窄组血清HCY水平（12.77±8.05）μmmol/L，中度狭窄组为（16.01±8.39）μmmol/L，重度狭窄组为（22.20±20.29）μmmol/L，重度狭窄组与中度狭窄组、轻度狭窄组的血清HCY水平比较，差异有统计学意义（P<0.05）。结论 HCY在头颈动脉粥样硬化中起着一定作用，HCY对头颈部动脉粥样硬化的作用机制及长期影响有待深入研究。