严重膝关节炎患者跌倒情况分析

Analysis of falls in patients with severe knee arthritis

目的调查年龄>65岁的严重膝关节炎患者跌倒的频率、机制、地点、跌倒时正在做的活动、受伤的情况以及测试身体状况,其次是研究年龄、性别、慢性疾病、社交活动、身体其他部位疼痛以及和生活质量相关的指标(如疼痛、僵硬、机体功能和动态稳定性)对跌倒概率的影响。方法纳入自2011-05—2012-05行全膝关节置换术的75例重度膝关节炎患者,当面询问过去一年的跌倒史,采用SF-36简易健康调查表评估患者生活质量,WOMAC评分评估术后效果,来回试验评估患者的机动性以及静态和动态稳定性。结果本研究中46例(61.3%)在过去的一年中发生过跌倒,跌倒的主要原因是被绊倒。75例的SF-36生理因素评分(34.39±6.97)分,SF-36精神因素评分(37.16±8.84)分;WOMAC总分(825.74±307.33)分,疼痛(223.10±86.43)分,僵硬(57.52±42.46)分,生理功能(538.93±257.18)分;来回试验(13.27±4.31)s。单因素分析发现,跌倒组和未跌倒组的年龄、性别、BMI、合并其他部位疼痛、合并慢性疾病、社交活动、其他部位关节置换、SF-36简易健康量表、WOMAC评分、来回试验比较差异无统计学意义(P>0.05)。结论严重膝关节炎患者发生跌倒的风险较大,应尽早接受膝关节置换手术治疗,以改善膝关节功能,降低跌倒受伤的风险。

Objective To investigate the history of falls including frequency, mechanism, and location of falls, activity during falling, injuries from falls and physical status of the patients aged over 65 years old with severe knee arthritis, and determine the effect of age, gender, chronic diseases, social affair, pain of other parts of body and quality of life related indicators （stiffness, physical function and dynamic stability） on frequency of falls. Methods The study was conducted on 75 patients scheduled for total knee replacement due to severe knee arthritis. Patients were personally interviewed for fall history and asked to complete questionnaires, such as the 36-item short form health survey （SF-36） and the Western Ontario and McMaster universities arthritis index （WOMAC） and Turn up and go test （TUG） to evaluate patient＇s mobility and static and dynamic stability. Results The frequency of falls was 61.3% for the past year. The main cause of falling was stumbling. The SF-36 score of physiological factors in 75 cases was （34.39±6.97）, SF-36 score of mental factors was （37.16±8.84）; the total score of WOMAC was （825.74±307.33）, pain （223.10±86.43）, stiffness （57.52±42.46）, physiological function （538.93±257.18） and TUG （13.27±4.31）s. Single factor analysis showed that there were no significant differences in age, gender, BMI, and other parts of pain, chronic diseases, social activities and other parts of joint replacement, SF-36 score, WOMAC, and TUG between the fall group and non fall group （P 〉0.05）. Conclusion Patients with severe knee arthritis are at greater risk of falling, should undergo total knee replacement as early as possible, which can improve knee function and reduce the risk of falls and injuries.