老年患者跌倒原因的调查

Investigation on Tumble of Elderly Patients

目的调查并分析老年患者跌倒的危险因素。方法采用问卷调查法,对2009年2月至2010年2月解放军总医院第一附属医院360例住院时间在2周以上、年龄65岁以上、意识清楚的老年患者（卧床患者除外）进行调查。结果 360例患者中,134例患者曾发生过跌倒,跌倒发生率为37.22%;65~74岁患者跌倒发生率为25.5%,75~84岁患者跌倒发生率为41.42%,85岁以上患者跌倒发生率为61.9%,随着年龄增加跌倒发生率增加（χ2=11.17,P〈0.05）;女性患者的跌倒发生率（48.72%）比男性患者的跌倒发生率（28.43%）高（χ2=7.23,P〈0.05）;跌倒2次以上的患者占跌倒总人数的34.33%,说明有跌倒史的患者有再次跌倒的风险;肌力不足、高血压、眩晕、环境等因素往往会导致跌倒。结论随着年龄的增加,对防止老年患者跌倒的关注应该增加;应该更多地关注女性患者,注意患者有无骨质疏松等;住院患者要询问跌倒史,对有跌倒史的患者应该予以更多关注;跌倒往往导致严重的后果,尽早治疗高血压及眩晕等疾病,创造有利于维护老年人安全的环境,住院期间对老年患者做好防跌倒的知识宣教,从而有效预防老年住院患者跌倒事件的发生。

Objective To explore and analyze the risk factors of tumble of elderly patients.Methods From February 2009 to February 2010,questionnaires were adopted to investigate 360 conscious patients（except bedridden patients）whose age were older than 65 years and stayed for two weeks or more in our ward of the First Affiliated Hospital of General Hospital of PLA.Results Among the 360 patients,tumble occured in 134 patients and the total incidence of tumble was 37.22%.For patients aged 65-74,the incidence was 25.5%.For patients aged 75-84,the incidence was 41.42%.For those older than 85,the incidence was 61.9%.The incidence of tumble was increased with age（P0.05）.For female patients,the incidence was 48.72%,which was significantly higher than that of male（28.43%）patients（P0.05）.Patients with history of tumble more than twice occupied 34.33% of all the patients,which indicated that patients with tumble history had a tendency to fall down again.Muscle weakness,high blood pressure,dizziness for disease and environment factors often led to fall down.Conclusion More attention should be paid to elderly patients with their increased age.More attention should be attached to female patients,especially whether they are with osteoporosis.The history of tumble should be confirmed.Patients with tumble history deserve more attention due to its severe consequences.Falling events in elderly inpatients can be effectively prevented by early treatment of hypertension and dizziness to create a safe environment for elderly patients and tumble prevention education.