上海市长宁区老年脑卒中患者跌倒与跌伤流行病学特征分析  

Epidemiological features of falls and fall-related injuries among community-dwelling patients with stroke in Changning district of Shanghai

作　　者：姜玉[1] 夏庆华[1] 胡嘉[1] 周鹏[1] 胡越[1] 李玉华[1] 

机构地区：[1]上海市长宁区疾病预防控制中心慢性病防制科,上海200051

出　　处：《中国预防医学杂志》2016年第3期193-196,共4页Chinese Preventive Medicine

基　　金：上海市长宁区卫生局科研课题(20114GW07001)

摘　　要：目的了解我国城市社区居住的脑卒中患者跌倒流行病学现状。方法采用随机抽样的方法选择居住在上海市长宁区的60岁以上脑卒中患者1 498人,调查过去1年的跌倒和跌伤发生情况。结果脑卒中患者跌倒年发生率为28.91%,其中3.93%因为卒中发作而跌倒。跌伤率为18.22%,骨折率为5.47%。跌倒率随年龄增加而升高,后遗症显著增加跌倒发生率（χ2=14.257,P〈0.01）,而不同卒中类型、累及部位、时间间隔卒中患者间差异无统计学意义。跌倒最主要的原因是腿发软（34.21%）、头晕（29.73%）、运动中没保持平衡（17.11%）。跌伤后,因卒中跌倒的患者全部住院治疗,36.36%需要120急救服务。非卒中跌倒的患者44.66%到医院就诊,8.40%需要120急救服务。医疗费用中位数为705（80~3 525）元。7.25%的非卒中跌倒的患者因跌倒失去基本生活自理能力。结论社区居住的老年脑卒中现患病例跌倒发生率高,跌倒后果严重。虽然卒中发作可导致跌倒,但其最主要原因是由于卒中后遗症等其他因素导致的跌倒。卒中患者应作为干预的重点人群,采取优先干预措施。Objective To understand the epidemiological characteristics of falls and fall-related injuries among community-dwelling patients with stroke in Changning district of Shanghai. Methods A random sampling method was applied in this study to recruit patients with stroke aged older than 60 years who lived in communities of Changning district,and a self-designed questionnaire survey was conducted. Results A total of 1 498 stoke patients were surveyed.The annual incidences of falls,fall-related injuries and fractures were 28.91%,18.22% and 5.47%,respectively,with the overall incidence of 28.91%,and 3.93% of falls were due to the onset of stroke.There were significant differences of fall incidences between those with and without stroke related sequelae（χ2=14.257,P〈0.01）,but no significant differences were observed between patients with different types of stroke,different afflicted body parts and different interval from last onset of stroke.The main causes of falls reported included foot weakness,dizziness and loss of balance during walk.After a fall,all of those who fell due to onset of a stroke were hospitalized and 36.36%required ambulance service.For other patients,44.66% needed medical treatment,and 8.40% needed ambulance service.The median medical expense was 705 Yuan.7.25% of patients with fall related injuries lost their abilities to be independent in daily life due to falls. Conclusions Because of high fall incidence and severe consequences,falls and fall-related injuries significantly increase the medical service cost and pose heavy burden on family and society.Therefore,proper intervention should be introduced to prevent falls of stroke patients.

关 键 词：社区 脑卒中 跌倒 流行病学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]