住院精神障碍患者跌倒致伤的情况分析

Analysis on Injury Cases of Fall Down of Mental Disorder Inpatients

目的了解住院精神障碍患者跌倒致伤情况,为预防跌倒的科学管理提供依据。方法回顾性分析2006-2010年在上海市民政第二精神卫生中心住院期间发生跌倒致伤的85例患者的年龄、精神科用药、合并疾病以及损伤类型等情况。结果 85例发生跌倒的精神障碍患者中,38例有合并慢性病史,其中高血压者15例,占39.5%;糖尿病者10例,占26.3%;心脏疾病者5例,占13.2%。精神障碍患者跌倒后的损伤主要为骨折,以前臂及手指骨骨折最多见。50～70岁骨折发生率最高,为55.9%;而<50岁的精神障碍患者的开放性损伤、颅脑损伤、软组织损伤发生率分别为22.6%、12.9%和25.8%。采用经典用药(即传统抗精神障碍药物,主要包括吩噻嗪类、硫杂蒽类、丁酰苯类、苯酰胺类药物)治疗的精神障碍患者发生骨折、开放性损伤、颅脑损、软组织损伤均较多,分别为36.4%、26.9%、13.6%和21.1%。结论跌倒在精神障碍患者中较为常见,应提高对跌倒危害性的认识,采取有效的预防措施,以控制跌倒对精神障碍患者造成的健康损害。

Objective To provide basis for the effective management of fall down by analyzing the injury cases of fall down of mental disorder inpatients.Methods The data of 85 cases of menta1 disorder inpatients who developed fall down from 2006 to 2010 were analyzed retrospectively on their age,psychotropic medication,combined diseases and type of injury.Results Of 85 menta1 disorder inpatients who developed fall down,38 were observed with history of chronic diseases including 15 cased of hypertension（39.5%）,10 cases of diabetes（26.3%） and 5 cases of heart diseases（13.2%）.Fracture was the main injury types of fall down of mental disorder inpatients.The incidence of forearm fracture of upper limb was the highest.The highest incidence of fracture（55.9%） was observed in patients aged 50-70 years.For those below 50 years old,the incidences of open injury,head injury and soft tissue injury were 22.6%,12.9% and 25.8% respectively.For the psychiatric patients treated with classic drug treatment（traditional anti-mental disorder drugs,including the phenothiazines,Thioxanthone,butyrophenone,benzene lactam drugs）,the incidences of fractures,open injuries,brain damage and soft tissue injury were 36.4%,26.9%,13.6% and 21.1%,respectively.Conclusion Fall down is quite common among mental disorder inpatients,so we should improve the cognition of fall risk,take effective preventive measures and reduce healthy injury of fall down.