老年帕金森病病人多次跌倒的临床特点及危险因素分析  

Analysis of clinical features and risk factors of recurrent falls in elderly patients with Parkinson′s disease

作　　者：陈娇燕[1] 刘凯[1] 陈英[1] 李秋敏[1] 林桂香[1] 韩坤元[1] 仝珊[1] 周晓莉[1] Chen Jiaoyan;Liu Kai;Chen Ying(Hainan General Hospital,Hainan 570311 China)

机构地区：[1]海南省人民医院

出　　处：《护理研究》2018年第24期3861-3865,共5页Chinese Nursing Research

基　　金：2017年海南省卫生计生行业科研项目;编号:16A200043

摘　　要：[目的]比较老年帕金森病病人1次跌倒和多次跌倒的临床特征,并探讨多次跌倒的影响因素。[方法]将随访期6个月内未发生跌倒的120例帕金森病病人作为随访对象,进行1年随访。随访期后,采用巢式病例对照研究分析1次跌倒和多次跌倒病人的资料。[结果]通过1年随访,42例(35.0%)病人发生跌倒,其中19例(45.2%)发生1次跌倒,23例(54.8%)发生多次跌倒。1次跌倒多发生在室内,多次跌倒多发生在室外(P=0.017)。滑倒和冻结步态在1次跌倒中较常见(P=0.035和P=0.024);多次跌倒中以下肢无力多见(P=0.023)。帕金森病跌倒病人中最常见的损伤是挫伤。既往6个月内无跌倒发生的老年帕金森病病人多次跌倒的危险因素是较差的运动性能(OR=1.06,95%CI为1.01～1.11,P=0.022)。[结论]平时活动性能较差的老年帕金森病病人更容易发生多次跌倒,但该结论还需要更大样本的研究进行进一步验证。Objective:To compare the clinical features of single fall and recurrent falls in elderly patients with Parkinson′s disease,and to explore the influencing factors of recurrent falls.Methods:A total of120patients with Parkinson′s disease who did not fall within6months of follow up were followed up for1year.After the follow up period,the data of patients with single fall and recurrent falls were analyzed using a nested case control study.Results:42patients(35.0%)experienced falls,of which19(45.2%)had single fall and23(54.8%)had recurrent falls.Single fall often occurred indoors and recurrent falls occurred outdoors(P=0.017).Slipping and freezing gait were more common in single fall(P=0.035and P=0.024).Weakness of the lower limbs was more common in recurrent falls(P=0.023).The most common injury in Parkinson′s falls was contusion.The risk factors of recurrent falls in elderly Parkinson′s patients who had not fallen in the previous6months were poor motor performance(OR=1.06,95%CI1.01~1.11,P=0.022).Conclusions:Elderly patients with Parkinson′s disease with poor activity of daily living were more prone to recurrent falls,but this conclusion needs to be further verified with a larger sample of studies.

关 键 词：帕金森病 跌倒 损伤 影响因素 随访 日常活动能力 滑倒 冻结步态 

分 类 号：R47[医药卫生—护理学]