老年脑血管病跌倒患者平衡与步态的评定分析及护理对策

Evaluation and Nursing Countermeasures of Balance and Gait on Falls in the Elderly with Stroke

目的了解并分析老年脑血管病跌倒患者的平衡能力,提出针对性的护理措施,指导临床预防跌倒,保证护理安全。方法对52例老年脑血管病患者进行跌倒情况调查,采用Tinetti平衡与步态评定量表评定其平衡与步态,寻找跌倒发生与平衡能力各因素之间的关系。结果有87.6%的老年脑血管病患者平衡及步态两者相加总分<19分,显示有跌倒的危险,即刻站立平衡、转立平衡、胸部轻推反应、闭眼站立平衡不能很好完成者居多。其中在即刻站立平衡、转立平衡上跌倒≥3次者比跌倒1次者下降明显,有显著差异(P<0.05)。结论老年脑血管病患者在即刻站立及转立时容易发生多次跌倒,该两方面是护理人员预防工作的重点。详细观察老人平衡功能和步态,可为采取护理措施提供良好的依据。

Objective To investigate the ability of balance in the elderly with stroke and fall, and to advice corresponding nursing procedure so as to prevent fall and guarantee patient safety. Methods Fifty-two elderly patients with stroke were surveyed for falls. Tinetti Assessment Tool was used to evaluate balance and gait. The relationship between fall and postural stability factors was analyzed. Results The number of patients with total score （i. e. balance score plus gait score）below 19 accounted for 87.6%, suggesting risk of fall. Most of the patients could not perform immediate standing balance, turning 360 degrees, nudged, and standing balance with eyes closed very well. The decrease in ability of balance in immediate standing balance and turning 360 degrees test in patients who fell for no less than three times was significantly more than that in patients who fell only once（ P 〈 0.05 ）. Conclusion Falls among elderly stroke patients occur more easily in immediate standing and turning. Effective falls prevention programs should target at the two balance factors. In order to provide effective nursing service, nursing staff should observe the balance and gait in the elderly carefully.