骨质疏松性脊柱骨折临床诊断分析

目的 探讨骨质疏松性脊柱骨折在老年人中发病情况以及早期诊断在防治骨质疏松症中的意义。方法 总结2002年7月～2004年6月在我院社区腰背疼痛老年病人90例及入院老年骨折病人38例。共128例，其中女性103例，男性25例；手术患者女性27例，男性11例。所有病例均经X线脊椎正、侧片检查，除外其他骨科疾病，并判断其是否存在有骨质疏松性脊柱骨折并分析误、漏诊率。结果 128例患者中56．25％发现有一个或多个椎体骨折(72例)，72例骨折患者中17例存在两个椎体骨折(13．28％，17／128)，5例存在两个以椎体骨折(5／128，3．9l％)。72例骨折患者中有4例患者从未就诊，68例平均有1～10次病历就诊史。在有就诊史的68例患者中，51．47％存在明显的漏、误诊(35例)。结论 正确诊断骨质疏松性脊柱骨折对于及时治疗骨质疏松症是极为重要；首次非暴力脊柱骨骨折的正确诊断为预防再次出现骨质疏松性骨折的发生有重要现实意义。

Analysis the statue of osteoporotic vertebral fracture diagnosis

Objective To access the diagnosis rate of osteoporotic vertebral fracture in aged people,and to find the significance of the vertebrae fracture diagnosis in osteoporosis treatment.Method Recruit 90 patients with back pain from community randomly and 38 non-vertebral fracture cases who has hospitalized in our hospital form July 2002 to August 2004.Total cases are 128 (female 103,male 25);Inpatient of non vertebral fracture patient 38,(female 27,male 11).All the cases have done X-ray exam.And all cases were confirmed that there were no orthopedics diseases other than osteoporosis and fracture.Evaluating how many many patients have vertebral fracture without clinical diagnose or with normal diagnose by mistake.Results 72 cases were diagnosed with on or multi-vertebrae fracture (72/128,56.25%).Among of them,17 cases were diagnosed with two vertebrae fracture (17/128,13.28%);5 cases were diagnosed with more than two vertebrae fracture (5/128,3.91%).4 patients have never seen doctor.68 patients have seen doctor one to ten times.35 cases (51.47% of all cases) have diagnosed by mistakeand missed fracture diagnosis.Conclusion It is important to diagnose the first osteoporosis vertebral fracture which is the major step to prevent consequent osteoporotic fracture.