杨菁, 聂子淮, 滕斌, 庞小芬. 基于FRAX风险评估的分层管理在社区老年骨质疏松症病人中的应用研究[J]. 蚌埠医学院学报, 2022, 47(2): 254-258. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.028
    引用本文: 杨菁, 聂子淮, 滕斌, 庞小芬. 基于FRAX风险评估的分层管理在社区老年骨质疏松症病人中的应用研究[J]. 蚌埠医学院学报, 2022, 47(2): 254-258. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.028
    YANG Jing, NIE Zi-huai, TENG Bin, PANG Xiao-fen. Study on the application value of hierarchical management based on FRAX risk assessment in elderly community patients with osteoporosis[J]. Journal of Bengbu Medical College, 2022, 47(2): 254-258. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.028
    Citation: YANG Jing, NIE Zi-huai, TENG Bin, PANG Xiao-fen. Study on the application value of hierarchical management based on FRAX risk assessment in elderly community patients with osteoporosis[J]. Journal of Bengbu Medical College, 2022, 47(2): 254-258. DOI: 10.13898/j.cnki.issn.1000-2200.2022.02.028

    基于FRAX风险评估的分层管理在社区老年骨质疏松症病人中的应用研究

    Study on the application value of hierarchical management based on FRAX risk assessment in elderly community patients with osteoporosis

    • 摘要:
      目的探讨基于FRAX风险评估的分层管理对社区老年骨质疏松症病人疾病认知及健康相关行为的影响。
      方法采用分层随机抽样的方法,选择2017年6月至2018年7月上海市黄浦区社区老年骨质疏松症病人126例为研究对象,根据时间分为对照组(2017年6-12月)62例、观察组(2018年1-7月)64例。2组均给予病人相同的健康管理内容;对照组给予发放健康教育手册、集中宣教、个体指导、社会支持、随访管理等常规护理干预;观察组联合应用基于FRAX风险评估的分层管理。随访12个月,比较2组疾病认知水平、健康相关行为、25羟维生素D(25OHD)及骨密度(BMD)水平和跌倒与骨折发生率。
      结果随访12个月后,观察组老年骨质疏松症病人骨质疏松症危险因素、运动知识、钙知识、疾病认知总分均高于对照组,诊疗相关行为、营养相关行为、运动相关行为、健康相关行为总分均高于对照组,25OHD、腰椎L3~4及股骨颈BMD水平均高于对照组,差异均有统计学意义(P < 0.05~P < 0.01);跌倒与骨折发生率为6.45%,低于对照组的18.97%(P < 0.05)。
      结论基于FRAX风险评估的分层管理有助于提高社区老年骨质疏松症病人疾病认知水平,促进健康相关行为的养成,改善维生素D及BMD水平,预防跌倒、骨折发生。

       

      Abstract:
      ObjectiveTo explore the effects of hierarchical management based on FRAX risk assessment on the disease cognition and health-related behaviors of community elderly patients with osteoporosis.
      MethodsA total of 126 elderly patients with osteoporosis from June 2017 to July 2018 in community of Huangpu district Shanghai were selected by stratified random sampling method.According to the time, the patients were divided into the observation group(from January to July 2018, 64 cases) and control group(from June to December 2017, 62 cases).Two groups were given the same health management content.The control group was given health education manual, centralized education, individual guidance, social support, follow-up management and other routine nursing intervention.The observation group was additionally given the hierarchical management based on FRAX risk assessment on the basis of control group.Two groups were followed up for 12 months.The disease cognition level, health related behavior, 25 hydroxyvitamin D(25OHD) and bone mineral density(BMD) levels and incidence rates of fall and fracture were compared between two groups.
      ResultsAfter 12 months of following-up, the total scores of osteoporosis risk factors, exercise knowledge, calcium knowledge and disease cognition in observation group were higher than those in control group, the total scores of diagnosis and treatment-related behavior, nutrition-related behavior, exercise-related behavior and health-related behavior in observation group were higher than those in control group, and the levels of 25OHD and BMD in lumbar 3-4 and femoral neck in observation group were higher than those in control group(P < 0.05 to P < 0.01).The incidence rates of fall and fracture in observation group(6.45%) were lower than those in control group(18.97%) (P < 0.05).
      ConclusionsHierarchical management based on FRAX risk assessment can help to improve the cognitive level of disease, promote the formation of health-related behaviors, improve vitamin D and BMD levels, prevent falls and fractures in community elderly patients with osteoporosis.

       

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