社区骨质疏松症的综合防治
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摘要
随着人口老龄化程度的加剧,骨质疏松症患者的数量逐年上升,由此导致老年人致残、致死的人数增加,给家庭和社会带来沉重的负担。目前,在大型综合医院对骨质疏松的治疗比较规范,但在社区医院对于骨质疏松症的诊治仍然存在认知上的差异。面对社区骨质疏松症认知诊治率偏低的问题,我们应积极强化对社区全科医生的培训,使其对骨质疏松症的认知和诊治水平得到提升,充分发挥社区全科医生的健康守门人作用,进一步普及防治骨质疏松症的健康知识,提高居民对骨质疏松症的防治意识,降低骨质疏松性骨折的发生率,提高其生存质量。
With the aging of the population, osteoporosis patients are increasing year by year, which leads increased disability and mortality rate in the elderly, and brings a heavy burden to the family and society. At present, the anti-osteoporosis treatment in large general hospitals is more standardized, but there are still cognition differences in the diagnosis and treatment of osteoporosis in the community. In view of the low rate of cognitive diagnosis and treatment of osteoporosis in the community, we should actively strengthen the training of community general practitioners in order to improve their cognition and diagnosis and treatment of osteoporosis, to give full play to the health gatekeeper role of community general practitioners, to popularize the health knowledge of prevention and treatment of osteoporosis, to improve residents' awareness of the prevention and treatment of osteoporosis, to reduce the incidence of osteoporotic fractures, and to improve their quality of life.
With the aging of the population, osteoporosis patients are increasing year by year, which leads increased disability and mortality rate in the elderly, and brings a heavy burden to the family and society. At present, the anti-osteoporosis treatment in large general hospitals is more standardized, but there are still cognition differences in the diagnosis and treatment of osteoporosis in the community. In view of the low rate of cognitive diagnosis and treatment of osteoporosis in the community, we should actively strengthen the training of community general practitioners in order to improve their cognition and diagnosis and treatment of osteoporosis, to give full play to the health gatekeeper role of community general practitioners, to popularize the health knowledge of prevention and treatment of osteoporosis, to improve residents' awareness of the prevention and treatment of osteoporosis, to reduce the incidence of osteoporotic fractures, and to improve their quality of life.
引文
[1] Bliuc D, Nguyen ND, Alarkawi D, et al. Accelerated bone loss and increased post-fracture mortality in elderly women and men[J]. Osteoporos Int, 2015, 26(4):1331-1339.
[2] 贺丽英, 孙蕴, 要文娟,等. 2010年～2016年中国老年人骨质疏松症患病率Meta分析[J]. 中国骨质疏松杂志, 2016, 22(12):1590-1596.
[3] Wright NC, Looker AC, Saag KG, et al. The Recent Prevalence of Osteoporosis and Low Bone Mass in the United States Based on Bone Mineral Density at the Femoral Neck or Lumbar Spine[J]. Journal of Bone & Mineral Research, 2014, 29(11):2520-2526.
[4] Johnell O, Kanis J. Epidemiology of osteoporotic fractures[J]. Osteoporosis International, 2005, 16(Suppl 2):S3-7.
[5] Sun Y, Xueping DU, Gao M, et al. Survey of the status of diagnosis and treatment of osteoporosis in the communities in Beijing[J]. Chinese Journal of Osteoporosis, 2013, 19(5):522-524.
[6] Wang O, Hu Y, Gong S, et al. A survey of outcomes and management of patients post fragility fractures in China[J]. Osteoporosis International, 2015, 26(11):2631-2640.
[7] Nayak S, Edwards DL, Saleh AA, et al. Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density[J]. Osteoporosis International, 2015,26:1543-1554.
[8] Tai V, William L, Andrew G, et al. Calcium intake and bone mineral density:systematic review and meta-analysis[J].BMJ,2015, 351(24):h4183.
[9] Zhao R, Feng F, Wang X. Exercise interventions and prevention of fall-related fractures in older people: a meta-analysis of randomized controlled trials[J]. International Journal of Epidemiology, 2017, 46(1):149-161.
[10] Alamri FA, Saeedi MY, Mohamed A, et al. Knowledge, attitude, and practice of osteoporosis among Saudis: a community-based study[J]. Journal of the Egyptian Public Health Association, 2015, 90(4):171-177.
[11] 邹军, 章岚, 任弘,等. 运动防治骨质疏松专家共识[J]. 中国骨质疏松杂志, 2015, 21(11):1291-1302.
[12] Eleftheriou KI, Rawal JS, James LE. Bone structure and geometry in young men: the influence of smoking, alcohol intake and physical activity[J]. Bone, 2013, 52(1):17-26.
[13] Gaksch M, Jorde R, Grimnes G, et al. Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium[J]. PLoS One, 2017, 12(2):e0170791.
[14] Beck BR, Snow CM. Bone Health Across the Lifespan—Exercising Our Options[J]. Exerc Sport Sci Rev, 2003, 31(3):117-122.
[15] Anderson-Wurf J,Harding C,Seal A.Increasing the knowledge, identification and treatment of osteoporosis through education and shared decision-making with residents living in a retirement village community[J]. Australasian Journal on Ageing, 2018,37(1):E17-E22.
[16] Komm BS, Chines AA. An update on selective estrogen receptor modulators for the prevention and treatment of osteoporosis[J]. Maturitas, 2012, 71(3):221-226.
[17] MacLean C, Newberry S, Maglione M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis[J]. Ann Intern Med,2008, 148(3):197.
[18] Walters S, Khan T, Ong T, et al. Fracture liaison services: improving outcomes for patients with osteoporosis[J]. Clinical Interventions in Aging, 2017,12:117-127.
[19] Evenson AL, Sanders GF. Educational Intervention Impact on Osteoporosis Knowledge, Health Beliefs, Self-Efficacy, Dietary Calcium, and Vitamin D Intakes in Young Adults[J]. Orthopedic Nursing, 2016, 35(1):30-36.
[2] 贺丽英, 孙蕴, 要文娟,等. 2010年～2016年中国老年人骨质疏松症患病率Meta分析[J]. 中国骨质疏松杂志, 2016, 22(12):1590-1596.
[3] Wright NC, Looker AC, Saag KG, et al. The Recent Prevalence of Osteoporosis and Low Bone Mass in the United States Based on Bone Mineral Density at the Femoral Neck or Lumbar Spine[J]. Journal of Bone & Mineral Research, 2014, 29(11):2520-2526.
[4] Johnell O, Kanis J. Epidemiology of osteoporotic fractures[J]. Osteoporosis International, 2005, 16(Suppl 2):S3-7.
[5] Sun Y, Xueping DU, Gao M, et al. Survey of the status of diagnosis and treatment of osteoporosis in the communities in Beijing[J]. Chinese Journal of Osteoporosis, 2013, 19(5):522-524.
[6] Wang O, Hu Y, Gong S, et al. A survey of outcomes and management of patients post fragility fractures in China[J]. Osteoporosis International, 2015, 26(11):2631-2640.
[7] Nayak S, Edwards DL, Saleh AA, et al. Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density[J]. Osteoporosis International, 2015,26:1543-1554.
[8] Tai V, William L, Andrew G, et al. Calcium intake and bone mineral density:systematic review and meta-analysis[J].BMJ,2015, 351(24):h4183.
[9] Zhao R, Feng F, Wang X. Exercise interventions and prevention of fall-related fractures in older people: a meta-analysis of randomized controlled trials[J]. International Journal of Epidemiology, 2017, 46(1):149-161.
[10] Alamri FA, Saeedi MY, Mohamed A, et al. Knowledge, attitude, and practice of osteoporosis among Saudis: a community-based study[J]. Journal of the Egyptian Public Health Association, 2015, 90(4):171-177.
[11] 邹军, 章岚, 任弘,等. 运动防治骨质疏松专家共识[J]. 中国骨质疏松杂志, 2015, 21(11):1291-1302.
[12] Eleftheriou KI, Rawal JS, James LE. Bone structure and geometry in young men: the influence of smoking, alcohol intake and physical activity[J]. Bone, 2013, 52(1):17-26.
[13] Gaksch M, Jorde R, Grimnes G, et al. Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium[J]. PLoS One, 2017, 12(2):e0170791.
[14] Beck BR, Snow CM. Bone Health Across the Lifespan—Exercising Our Options[J]. Exerc Sport Sci Rev, 2003, 31(3):117-122.
[15] Anderson-Wurf J,Harding C,Seal A.Increasing the knowledge, identification and treatment of osteoporosis through education and shared decision-making with residents living in a retirement village community[J]. Australasian Journal on Ageing, 2018,37(1):E17-E22.
[16] Komm BS, Chines AA. An update on selective estrogen receptor modulators for the prevention and treatment of osteoporosis[J]. Maturitas, 2012, 71(3):221-226.
[17] MacLean C, Newberry S, Maglione M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis[J]. Ann Intern Med,2008, 148(3):197.
[18] Walters S, Khan T, Ong T, et al. Fracture liaison services: improving outcomes for patients with osteoporosis[J]. Clinical Interventions in Aging, 2017,12:117-127.
[19] Evenson AL, Sanders GF. Educational Intervention Impact on Osteoporosis Knowledge, Health Beliefs, Self-Efficacy, Dietary Calcium, and Vitamin D Intakes in Young Adults[J]. Orthopedic Nursing, 2016, 35(1):30-36.