三种功能性移动能力测试工具评估维持性血液透析患者跌倒风险

Three functional mobility tests for assessing fall risk in maintenance hemodialysis patients

目的评定三种功能性移动能力测试工具在维持性血液透析（maintenancehemodialy—sis，MHD）患者跌倒风险预测中的有效性。方法选择2013年1月至2014年1月之间在南充市中心医院血液净化中心规律性MHD患者84例为研究对象，其中男37例，女47例，平均年龄为（54．5±15．9）岁。根据透析过程当中是否发生过一次或以上的跌倒将84例MHD患者分为跌倒组和非跌倒组，分别对所有患者进行站起测试（chairrisingtest，CRT）、计时起立行走测试（timeupandgotest，TUG）和走直线步态测试（tandemgaittest，TGT），记录测试结果并运用统计学方法分析三种工具与跌倒之间的相关性。结果在本次CRT试验中，能够独立完成该项动作并且时间≤10S的共25例，占29．76％；在TUG试验中，能够独立完成该项动作并且时间≤12S的共51例，占60．71％；在TGT试验中，能够独立完成该项动作并且步数超过8步的共52例，占61．90％。84例MHD患者透析过程中发生过跌倒的有23名，占27．38％，未发生过跌倒的有61例，占72．62％；其中因跌倒而发生骨折的患者共5例，均来自跌倒组，且全部为女性患者。跌倒组和非跌倒组患者在年龄、CRT时间、TUG时间、TGT步数之间的比较有统计学意义（P〈O．05），体质量指数之间的比较无统计学意义（P〉0．05）。Spearman相关性分析结果显示CRT时间、TUG时间、TGT步数之间与跌倒有无之间均具有相关性（P〈0．01）。结论CRT、TUG、TGT作为三种简单的移动能力测试工具能够有效的预测MHD跌倒风险。

Objective To evaluate the validity of three functional mobility tests for predicting fall risk in maintenance hemodialysis （MHD） patients. Methods 84 patients come from the blood purification center of Nanchong central hospital from January 2013 to January 2014 were fitted in this study;F/M = 47/37, mean age （54. 5 ±15.9） years. 84 patients were recruited and divided into two groups according to whether they had more than once fall in MHD： fall group and no-fall group. All patients were tested by chair rising test （CRT）, time up and go test （TUG） and tandem gait test （TGT）. The test results were recorded, and the correlation between three kinds of tool and fall was analyzed. Results In the CRT trials,25 patients can complete the action independent and the time less than 10 s , accounting for 29. 76% ; In TUG and TGT, the number of patients who can complete the action independent and the time less than 12 s or the steps more than 8 were 51 （60. 71%） and 52 （61.90%）, respectively. Among 84 patients, the fall group had 23 patients （27. 38%）, who has fell in the process of dialysis, and no-fall group had 61 patients （72. 62%）. Five female patients were frac- tured because of fall, accounting for 5.96%. There was significant difference in age, CRT time, TUG time and TGT step number （P〈0. 05）, but there was no significant difference in body mass indox be-tween two groups （P〉0. 05）. The Spearman regression analysis revealed that the CRT, TUG and TGT were related to falling （P〈0. 01）. Conclusions CRT, TUG and TGT as easily functional tests are useful for predicting falls in MHD patients.