基于功能独立性评定的脑卒中患者跌倒的预防

Prevention of falls in stroke patients based on functional independence measure

目的对脑卒中住院患者进行个体化干预指导,降低脑卒中患者跌倒发生率。方法将400例脑卒中患者根据住院时间分为对照组和观察组各200例,两组均采取常规跌倒预防措施。观察组在此基础上根据患者的功能独立性评定(FIM)情况,给予个体化的跌倒预防措施,如FIM值在108～125分,教会患者掌握平衡的技巧,鼓励患者在合适的时间进行活动,向患者及家属强调拐杖使用的重要性,帮助选择适合患者的拐杖,教会患者正确的使用方法等;对于FIM值在18～107分者,在以上基础上加强监护、器具的使用指导、严密看护、正确移动等措施。结果两组跌倒例次比较,差异有统计学意义(P<0.01)。结论根据患者FIM情况制定并实施的个体化跌倒预防措施,可有效降低脑卒中住院患者的跌倒次数。

Objective To decrease falls in hospitalized stroke patients by using individualized interventions.Methods Four hundred stroke patients were randomized into an observation group and a control group of 200 according to chronological order.Both groups were given routine measures to prevent falls,the observation group were subjected to individualized fall prevention measures based on the functional independence measure（FIM）.If patients＇ FIM ranged from 108 to 125,providing such measures as teaching ba-lance skills,encouraging participation in exercises,emphasizing importance of use of crutch,helping choose suitable crutch,tea-ching correct use of crutch,etc;if FIM ranged from 18 to 107,additionally providing measures including strengthening monitoring,giving guidance for use of instruments,closely watching and correctly moving.Results There was significant difference in occurrence of falls between the two groups（P0.01）.Conclusion Individualized fall prevention measures based on functional indepen-dence measure can decrease falls in hospitalized stroke patients.