| 李明,朱中蛟,孙晋保,等.骨折联络服务模式对老年骨质疏松性椎体压缩骨折手术患者的影响研究.骨科,2026,17(2): 136-140. |
| 骨折联络服务模式对老年骨质疏松性椎体压缩骨折手术患者的影响研究 |
| Impact of fracture liaison service model on elderly patients with osteoporotic vertebral compression fractures undergoing surgery |
| 投稿时间：2025-11-04 |
| DOI：10.3969/j.issn.1674-8573.2026.02.008 |
| CN KeyWords: 骨折联络服务 骨质疏松 椎体压缩骨折 再骨折 |
| EN KeyWords: Fracture liaison service Osteoporosis Vertebral compression fracture Refracture |
| Fund Project:枣庄市科技发展计划项目（2022NS37） |
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| CN Abstract: |
| 目的 探讨骨折联络服务（FLS）模式对老年骨质疏松性椎体压缩骨折（OVCF）手术患者的影响，为临床应用提供循证支持。方法 选择2022年9月至2023年8月在我科因OVCF接受椎体成形术治疗的患者400例，采用随机对照试验设计，将患者按1∶1比例分配至FLS组和对照组（采用传统医疗模式），每组200例。所有患者术后随访2年。比较2组患者术后抗骨质疏松治疗的依从性、术后1年的欧洲五维健康量表（EQ-5D-5L）效用值及Berg平衡量表评分；比较2组患者术前、术后2年的血清25-羟基维生素D水平，及其术后2年内的椎体再骨折率。结果 371例患者完成随访，FLS组189例，对照组182例，两组患者一般资料比较，差异均无统计学意义（P＞0.05）。FLS组患者抗骨质疏松基础药物治疗1年、2年的依从性优良率显著高于对照组（73.0% vs. 52.2%；46.6% vs. 22.0%），抗骨质疏松特异性药物治疗1年、2年的依从性优良率也显著高于对照组（68.8% vs. 43.4%；40.2% vs. 14.8%），差异均有统计学意义（P＜0.05）。术后1年随访，FLS组EQ-5D-5L效用值、Berg平衡量表评分分别为0.951（0.783，1.000）、（51.57±3.00）分，均高于对照组的0.792（0.734，0.951）、（48.96±4.41）分，差异有统计学意义（P＜0.05）；FLS组术后2年血清25-羟基维生素D水平为（26.82±5.51） ng/mL，显著高于对照组的（23.23±5.84） ng/mL，差异有统计学意义（P＜0.05）。FLS组2年内椎体再骨折发生率与对照组比较，差异无统计学意义（13.8% vs. 15.9%，P＞0.05）。结论 整合多维干预的FLS模式可有效提升OVCF患者术后抗骨质疏松治疗的依从性，改善患者生活质量。 |
| EN Abstract: |
| Objective To explore the impact of the fracture liaison service (FLS) model on elderly patients with osteoporotic vertebral compression fractures (OVCF) undergoing surgery, generating evidence-based support for clinical application. Methods From September 2022 to August 2023, 400 elderly patients with OVCF underwent vertebroplasty in our department. A randomized controlled trial design was adopted, and the patients were allocated in a 1∶1 ratio to the FLS group and the control group (conventional medical care), with 200 patients in each group. All patients were followed up for 2 years after vertebroplasty. The compliance with anti-osteoporotic treatment, the EQ-5D-5L and Berg Balance Scale scores at 1-year follow-up were compared. 25(OH) vitamin D level was evaluated preoperatively and 2 years postoperatively. Refracture incidence within 2 years after surgery was analyzed between the two groups. Results A total of 371 patients completed the follow-up, 189 cases in FLS group and 182 cases in control group. There was no significant difference in the general data between the two groups (P＞0.05). Compared with the control group, the excellent rate of basic anti-osteoporotic medication treatment compliance in the FLS group at 1 and 2 years follow-up was significantly higher (73.0% vs. 52.2%, 46.6% vs. 22.0%, P＜0.05), and the excellent rate of specific anti-osteoporotic medication treatment compliance in the FLS group at 1 and 2 years follow-up was also significantly higher (68.8% vs. 43.4%, 40.2% vs. 14.8%, P＜0.05). The EQ-5D-5L and the Berg Balance Scale scores in the FLS group were 0.951 (0.783, 1.000) and 51.57±3.00 respectively, significantly higher than 0.792 (0.734, 0.951) and 48.96±4.41 in the control group (P＜0.05). The blood 25(OH) vitamin D in the FLS group was significantly higher than that in the control group at 2 years follow-up after surgery [(26.82±5.51) vs. (23.23±5.84) ng/mL, P＜0.05]. There was no statistically significant difference in the incidence of vertebral refracture within 2 years follow-up between the FLS group and the control group (13.8% vs. 15.9%, P＜0.05). Conclusion The integrated multidimensional intervention-based fracture liaison service model can effectively improve patients' adherence to anti-osteoporotic treatment and enhance quality of life. |
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