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| 老年髋部骨折患者跌倒的现状研究 |
| Current situation of falls in elderly patients with hip fracture |
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| DOI：10.3969/j.issn.1006-7108.2020.06.019 |
| 中文关键词: 老年髋部骨折 现状研究 流行病学 |
| 英文关键词:fall elderly hip fracture cross-sectional study epidemiology |
| 基金项目:北京市医院管理局科研培育计划(PX2019015)；北京市保健委员会课题(京19-17号) |
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| 中文摘要: |
| 目的 探讨跌倒所致髋部骨折患者的流行病学情况。方法 收集2015年5月至2017年12月住院的年龄≥65岁脆性髋部骨折患者（A组），其中男性179例，女性456例；并以同期老年科住院的年龄≥65岁无髋部骨折病史患者作为对照（B组），其中男性29例，女性52例；应用SPSS 19统计学软件，采用二元Logistic回归分析危险因素。结果 ①635例髋部骨折老年患者，平均年龄（79.69±7.64）岁；有45.2%的跌倒是发生在家中，在家中的高发地点是卧室、起居室（占家中跌倒的72.1%），跌倒高发时间为入睡时间段，22:00~7:00占33.6%；有54.8%的跌倒是发生在户外，老人因使用非机动车产生的相关非暴力伤占到户外跌倒的28.2%。②发生跌倒后髋部骨折与老人行走时是否使用助行器（P=0.000）、步态（P=0.000）、优势手握力（P=0.000）、内科合并症CCI（P=0.006）有关；其中，行走时需要双手支撑辅助的老年患者比独立行走的老年患者发生髋部骨折的风险高4.7倍（95% CI:2.7,8.0）。③反复发生跌倒，即跌倒超高危老人与行走时是否使用助行器（P=0.000）、优势手握力（P=0.027）、内科合并症指数（P=0.027）相关。结论 老年人需尽可能的改善肌力及掌控平衡，居家出门少的老人需要注意卧室和起居室的布置，使用非机动车来助行的老人在上下车时及行驶时需要尽可能的缓慢来预防跌倒。随着人口老龄化程度的加剧，需要更多的社会力量来开展跌倒预防及跌倒损伤发生后的复健工作。 |
| 英文摘要: |
| Objective To investigate the epidemiology of falls in high-risk population, who suffered hip fracture. Methods A group of elderly patients with fragility hip fracture (group A), aged over 65 years, were hospitalized from May 2015 to December 2017, including 179 males and 456 females. A group of elderly patients with no history of hip fracture who were hospitalized at the same time with group A, aged over 65 years, were selected as the control group (group B), among them, 29 were males and 52 were females. IBM SPSS19 statistical software was used to analyze the risk factors using binary logistic regression analysis. Results ①635 elderly patients with hip fracture, the average age was 79.69±7.64; 45.2% of the falls occurred at home, the most common place in the house was the bedroom and living room (72.1% of the falls at home), and the most frequent falls occurred in the sleeping time, 22:00-7:00 (33.6%); 54.8% of the falls occurred outdoors, Non-motor vehicle-related non-violent injuries accounted for 28.2% of outdoor falls.②Hip fractures after a fall were related to whether the elderly used walking aids (P=0.000), gaitinstability (P=0.000), dominant hand grip (P=0.000) and Charlson Comorbidity Index (P=0.006). Among them, elderly patients who needed both hands to support and assist when they walking were more at risk of hip fracture than those who walked independently. The risk was 4.7 (2.7, 8.0) times higher.③Multiple falls was related to the use of walking aids (P=0.000), dominant handgrip strength (P=0.027) and Charlson Comorbidity Index (P=0.027). Conclusion To avoid falling, the elderly need to improve muscle strength and control balance as much as possible, the elderly who stay more at home need to pay attention to the layout of bedroom and living room, the elderly who use non-motor vehicles should get on and off the car as careful as possible and drive slowly. With the aging of the population, society should offer more efforts to prevent and help the patients recover from fall injury. |
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