骨质疏松骨折Osteoporosisfracture骨质疏松症是一种以骨量降低、骨微结构破坏、骨脆性增加、骨强度下降、骨折风险增大为特征的全身性、代谢性骨骼系统疾病Osteoporosisisasystemic,metabolicskeletalsystemcharacterizedbydecreasedbonemass,bonemicrostructuraldamage,increasedbonefragility,decreasedbonestrength,andincreasedriskoffracture骨质疏松骨折的特点及治疗难点：CharacteristicsandTreatmentDifficultiesofOsteoporosisfracture：1、骨质疏松骨折患者卧床制动后骨丢失加快，骨质疏松会加重；Osteoporosisfracturesinpatientswithbedpressureafterbonelossaccelerated，osteoporosiswillincrease2、骨折多为粉碎性，难以获得满意的固定；Fracturesaremostlycomminuted,itisdifficulttoobtainasatisfactoryfixation3、内固定易松动，植骨易被吸收；Internalfixationeasytoloose,bonegrafteasilyabsorbed4、骨折愈合时间长，易发生延迟愈合、不愈合；Fracturehealingtimeislong,pronetodelayedhealingornonunion5、再骨折风险大；Easytorecurfractureagain6、多为老年人，常合并多器官疾病，全身状况差；Patientsaremostlyelderly,oftenassociatedwithmultipleorgandiseases,pooroverallcondition7、致残率、致死率较高，严重影响生活质量和寿命。disabilityrateandfatalityratearehigher,seriouslyaffectingthequalityoflifeandlife.骨质疏松症的诊断标准：Diagnosticcriteriaforosteoporosis：双能X线吸收法（DXA）是目前国际公认的骨密度检查方法。DXAistheinternationallyrecognizedmethodofbonemineraldensity.•根据《中国人骨质疏松症诊断标准专家共识（第三稿2014版）》，年轻白人女性峰值骨量减少2.5标准差（-2.5SD）作为骨质疏松症的诊断标准。由于黄种人峰值骨量低于白种人等原因，国内推荐使用低于峰值骨量2标准差（-2.0SD），或者骨量下降25%作为诊断标准。•Accordingtothe"Chineseosteoporosisdiagnosticcriteriaexpertconsensus(thirdedition2014version)",youngwhitefemalepeakbonemassreductionof2.5standarddeviation(-2.5SD)asthediagnosticcriteriaforosteoporosis.Astheyellowpopulationofbonemassbelowthewhiteandotherreasons,thedomesticrecommendedlowerthanthepeakbonemass2standarddeviation(-2.0SD),orbonelossof25%asadiagnosticstandard.骨折后抗骨质疏松用药建议：Preventionofosteoporosisafterfracture:•根据中华医师学会骨科分会《骨质疏松骨质诊疗指南》，重要有如下几个要点：AccordingtotheChinesePhysiciansSocietyOrthopedicBranch"osteoporosisbonediagnosisandtreatmentguide",Themainpointsareasfollows:1、合理使用钙剂：Rationaluseofcalcium钙需要量为800-1200mg，骨折后补钙剂量应酌情适当加量。建议分次服用Calciumrequirementsforthe800-1200mg,Afterthefracture,thedosageofcalciumshouldbeappropriatelyadded.Suggestedfract.dos.2、推荐活性维生素D3RecommendeduseofvitaminD3建议用法为0.25-0.5ug/d，不仅能够增进肠钙吸收，促进骨形成和骨矿化，而且有助于增强肌力，增强神经肌肉协调性，防止跌倒倾向。Suggestedusageis0.25-0.5ug/d,notonlycanenhanceintestinalcalciumabsorption,promoteboneformationandbonemineralization,butalsohelptoenhancemusclestrength,enhanceneuromuscularcoordination,topreventthetendencytofall.•3、降钙素（Calcitonin）•如鲑鱼降钙素皮下或肌肉内注射50IU/d，鼻喷剂200IU/d。能够提高骨密度、改善骨质量、增强骨的生物力学性能、降低椎体骨质疏松骨折发生率，还有止痛作用。•Suchassalmoncalcitoninsubcutaneousorintramuscularinjectionof50IU/d,nasalspray200IU/d.Canimprovebonedensity,improvebonemass,enhancebonebiomechanicalproperties,Reducetheincidenceofosteoporoticvertebralfractures,aswellasanalgesiceffect.•但少数患者可有面部潮红、恶心等不良反应，其中多数患者症状可在数小时内自行缓解，有明显药物过敏史者禁用。•Butmayhavefacialflushing,nau...
