老年人跌倒的预防  

Prevention of falls in olderly people

作　　者：季颖[1] 阮祥燕[1] 刘忠厚 

机构地区：[1]北京妇产医院内分泌科,100006 [2]中国老年学学会骨质疏松委员会

出　　处：《中国骨质疏松杂志》2004年第3期380-383,376,共5页Chinese Journal of Osteoporosis

摘　　要：在老年人群中由跌倒引发的损伤与老年人的发病率和死亡率密切相关 ,预防老年人跌倒对维系老年人生活质量具有重要意义。流行病学显示欧美等国居住在社区的 6 5岁以上的老人每年有 30 %～ 4 0 %发生跌倒 ,长期生活在保健机构的老人有近半数的老人出现过跌倒 ;而日本和中国调查结果则低于 2 0 %。老年人的跌倒与年龄、性别、种族和功能水平 (日常生活活动能力和日常生活独立活动能力 )有关。跌倒的危险因素存在多因性 ,其中内因包括 :生理学因素、病理、药理和心理因素 ;外因有老年人穿鞋的情况和环境因素。因此 ,预防老年人跌倒需从病史问诊、标准的体格检查和步态及平衡能力检查进行全面的评估 ;对处于不同类别危险因素的个人 ,最有效的干预措施应是多元化干预和个体化指导相结合。干预措施包括 :①治疗相关疾病 ;②重新评估并调整所服药物 ;③纠正不良环境因素并补充有利平衡的辅助支持条件 ;④针对改善肌肉力量、平衡性和步态实施训练计划 ;⑤健康教育 ;⑥医疗保健人员对干预中再次发生的跌倒进行再评估 ;⑦利用政府和社会的力量保障及时到位的保健能力。Fall-related injury is not only correlated closely to the morbidity and mortality, but it is also of significant importance to their quality of life that prevents falls in old people. Epidemiological studies show that the incidences of falls is between 30% and 40% in the community-dwelling elderly over 65 years each year and about 50% in the long-term health care institutions in U.S.A and Europe. The survey results in Japan and China are lower than 20%. Falls of elderly are related to age, sex, race and functional level (activites of daily living and independent activities of daily living). Risk factors of falls are multifarious. Intrinsic factors consist of physiological, pathological, pharmacological, and psychlolgic factors.first factor or even cause injury. Extrinsic factors shoes and environmental conditions. Therefore, overall based on evaluation history, standard physical eamination, and examination of gait and balace is essential to prevention of falls. The most effective intervention measure should include multirious interventions and individualized directions to ivdividuals with different risk factors:① treatment of related diseases;②re-evaluation and adjustment of drugs;③improvement of hazardous environment, and supply of balance Qids ;④training for improving strength, balance and gait.⑤health education of old; ⑥re-evaluation of fall(s) during interventions by medical care workers;⑦ prompt medical care available from government and society.

关 键 词：跌倒 老年人 预防 干预措施 健康教育 危险因素 治疗 老人 体格检查 相关疾病 

分 类 号：R161.7[医药卫生—公共卫生与预防医学] R592