综合干预对预防社区老年人跌倒效果的meta分析  

Meta-analysis on effect of comprehensive intervention on preventing falls of the elderly in community

作　　者：陈立志 胡瑞霞[2] 邢京京 张军[1] CHEN Li-zhi;HURui-xia;XING Jing-jing;ZHANG Jun(Preventive Medicine Magazine A gency,Tianjin Center for Disease Control and Prevention,Tianjin,300011,China;School of Public Health,TianjinMedical University,Tianjin,300070,China)

机构地区：[1]天津市疾病预防控制中心预防医学杂志社,天津300011 [2]天津医科大学公共卫生学院,天津300070

出　　处：《职业与健康》2022年第24期3414-3419,共6页Occupation and Health

摘　　要：目的 系统评价综合干预对预防我国社区老年人的跌倒效果,为开展社区老年人跌倒预防工作提供参考。方法 对中国知网(China national knowledge infrastructure,CNKI)、万方数据库、维普网、PubMed和Cochrane Library数据库有关我国社区老年人跌倒综合干预效果的文献进行全面检索,检索时间为2010年1月1日-2022年2月19日。主要结局指标是跌倒发生率、跌倒知识知晓率及预防跌倒行为改变率。采用Cochrane协作组制定的“偏移风险评估工具”作方法学质量评价;Review Manager 5.3软件对研究结果进行meta分析。结果 共纳入12篇文献,均为随机对照试验。综合干预组共纳入2 693人,188例老人发生跌倒,跌倒率为6.98%;对照组共纳入2 662例,420例发生了跌倒,跌倒率为15.78%,两组跌倒率比较,差异有统计学意义[RR=0.44(95%CI:0.38~0.52)]。亚组分析结果显示,综合干预对高血压或糖尿病患者的干预效果更好[RR=0.29(95%CI:0.15~0.59)]。综合干预后,社区老年人在“跌倒可预防性”“体育锻炼可预防跌倒”方面认知知晓率较对照组高(均P<0.05),且社区老年人在“正确用药”“进行适当运动”行为方面较对照组有了更大改善(均P<0.05)。结论 综合干预相对于单一干预或无干预,对预防我国社区老年人,尤其是针对社区高血压和糖尿病患者,预防跌倒的效果更突出。建议采取综合性措施以预防老年人摔倒。Objective To systematically evaluate the effect of comprehensive intervention on the prevention of falls among the elderly in community in China,provide reference for the prevention of falls among the elderly in community. Methods A comprehensive search was conducted on the literature on the comprehensive intervention effect of falls among the elderly in the community in China from the China National Knowledge Infrastructure(CNKI),Wanfang database,VIP,PubMed and Cochrane Library database,with the retrieval time from January 1,2010 to February 19,2021. The main outcome indicators were the incidence of falls,the awareness rate of fall knowledge and the change rate of fall prevention behavior.The "deviation risk assessment tool" developed by Cochrane collaboration group was used for the methodological quality evaluation. The meta-analysis of the research results was conducted by Review Manager 5.3 software. Results A total of 12 articles were included,and they were all randomized controlled trials. A total of 2 693 people were included in the comprehensive intervention group,and 188 elderly people fell,with a fall rate of 6.98%. A total of 2 662 cases were included in the control group,and 420 cases fell,with a fall rate of 15.78%. The difference in the fall rate between the two groups was statistically significant[RR=0.44(95%CI:0.38-0.52)]. The sub-group analysis showed that comprehensive intervention had a better effect on patients with hypertension and diabetes[ RR=0.29(95%CI:0.15-0.59)]. After the comprehensive intervention,the cognitive awareness rates of the community elderly in the aspects of "falling prevention" and "physical exercise can prevent falling" both were higher than those of the control group(both P<0.05),and the behaviors of the community elderly in the aspects of "correct medication" and "proper exercise" had been greatly improved compared with those of the control group(both P<0.05). Conclusion Compared with single intervention or no intervention,comprehensive intervention is more effective in

关 键 词：跌倒 社区老年人 综合干预 META分析 

分 类 号：R181.3[医药卫生—流行病学]