骨折流行病学的城乡差异

随着我国社会发展和人口老龄化加剧，与骨质疏松相关的高能损伤和低能暴力导致的骨折数量不断增加。骨折在不同人群和身体不同部位的分布正在发生变化。然而，很少有研究报告骨折发生的季节、日期和时间点。此外，对农村和城市地区骨折流行病学特征的比较研究也很有限。为了解决这一问题，我们机构进行了一项回顾性研究，以比较农村和城市地区创伤性骨折的流行病学特征，并分析患者的人口统计学特征、骨折部位、受伤季节以及日期和时间点。

Purpose（目的）

本回顾性旨在对比分析农村与城市患者骨折的流行病学特征。

[Purpose: This study aimed to comparatively analyse the epidemiologic characteristics of fractures among inpatients from rural and urban areas.]

Methods（方法）

本研究回顾性分析了我院2017年1月至2017年12月收治的四肢、骨盆和脊柱创伤性骨折患者。来自农村和城市地区的患者分别被分为A组和B组。收集两组患者的年龄、性别、骨折部位分布、损伤机制、骨折发生的季节、日期和时间、住院时间、慢性并发症和住院死亡率等数据，并进行比较。

[Methods: This study retrospectively analysed patients with traumatic fractures of the limbs, pelvis and spine treated in our hospital from January 2017 to December 2017. Patients from rural and urban areas were classified into Group A and Group B, respectively. Data on age, sex, distribution of fracture locations, injury mechanism, season, date and time when the fracture occurred, length of hospital stay, chronic comorbidities and in-hospital mortality were collected, and compared between both groups.]

Results（结果）

共10046例患者(A组：4440例；男性3062人，女性1378人；B组：5606人；3374名男性和2232名女性)患有创伤性骨折。两组男女比例有显著性差异(P<0.001)。A组和B组患者年龄分别为41.9±21.6岁和45.0±23.5岁，差异有统计学意义(P<0.05)。损伤机制方面，最常见的是低能量损伤(A组：2110例，占47.5%；B组：3422起，占61.0%)两组中，其次是交通事故(A组：921起，占20.7%；B组：973人，占17.4%)。在多发伤患者中，最常见的损伤机制是交通事故(354起，46.1%)。A组178例(4.0%)，B组141例(2.5%)合并颅脑损伤。至于季节，两组骨折多发生在秋季(A组：1449例，占32.6%；B组：1518人，占27.3%)。

[Results: A total of 10,046 patients (Group A: 4,440; 3,062 males and 1,378 females and Group B: 5,606; 3,374 males and 2,232 females) with traumatic fractures were included. The male-to-female ratio was significantly different between both groups (P<0.001). In Groups A and B, the patients aged 41.9 ± 21.6 and 45.0 ± 23.5 years old, respectively, showing significant difference (P<0.05). As for injury mechanism, the most common one was low-energy injury (Group A: 2110, accounting for 47.5%; Group B: 3422, accounting for 61.0%) in both Groups, followed by traffic accidents (Group A: 921, accounting for 20.7%; Group B: 973, accounting for 17.4%). In patients with multiple injuries, the most common mechanism of injury is traffic accidents (354, 46.1%). There were 178 patients in Group A (4.0%) and 141 patients in Group B (2.5%) combined with head injury. As for season, both groups had most of the fractures in autumn (Group A: 1449, accounting for 32.6%; Group B: 1518, accounting for 27.3%).]

表1：城乡不同年龄骨折患者构成比的比较。

表2：合并慢性疾病对比。

表3：损伤机制对比。

表4：多发伤患者信息。

表5：城市与农村不同骨折部位比较。

表6：城市与农村开放性骨折类型比较。

表7：城市与农村骨折的季节性比较。

表7：城市与农村骨折的发生时间比较。

Conclusion（结论）

农村和城市创伤性骨折患者的流行病学特征在年龄分布、损伤机制、损伤部位和季节上有所不同。农村地区骨折风险高的患者比城市地区的患者年轻。在农村和城市地区，手腕和髋部分别是各自最常见的骨折部位。对于农村和城市人口来说，预防低能量导致的骨质疏松性骨折已经变得非常关键。减少交通事故的风险对于防止多重伤害仍然至关重要。

[Conclusion: The epidemiological features of patients with traumatic fractures in rural and urban areas are somewhat different in terms of age distribution, injury mechanism, injured body site and season. Patients with high risk of fractures in rural areas were younger than those in urban areas. Fractures more frequently occurred in the wrist and hips in rural and urban areas, respectively. Prevention of low-energyinduced osteoporotic fractures has become very critical for both rural and urban populations. Reducing the risk of traffic accident remains critical to prevent multiple injuries.]

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