脑卒中病人发生跌倒危险因素的Meta分析  

Risk factors of fall in stroke patients:a Meta-analysis

作　　者：田野 石成文 郝娇慧 李丽华[1] TIAN Ye;SHI Chengwen;HAO Jiaohui;LI Lihua(Mudanjiang Medical University,Heilongjiang 157000 China)

机构地区：[1]牡丹江医学院,黑龙江157000

出　　处：《循证护理》2023年第7期1149-1156,共8页Chinese Evidence-Based Nursing

基　　金：2022年牡丹江医学院研究生导师专项计划项目,编号:YJSZX2022149。

摘　　要：目的:系统评价脑卒中病人跌倒的危险因素,为预防脑卒中病人跌倒的发生提供依据。方法:通过计算机检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网(CNKI)、万方数据库、维普数据库(VIP)、中国生物医学文献数据库(CBM)共7个数据库,搜集关于脑卒中病人发生跌倒危险因素的文献,并应用RevMan 5.3软件对数据进行分析。结果:共纳入20篇文献,提取32个危险因素。Meta分析显示,脑卒中病人跌倒的发生与高龄[MD=2.37,95%CI(1.63,3.10),P<0.001]、既往跌倒史[RR=1.39,95%CI(1.09,1.77),P<0.05]、偏瘫[RR=1.25,95%CI(1.10,1.42),P<0.001]、忽视[RR=1.69,95%CI(1.34,2.12),P<0.001]、共济失调[RR=1.33,95%CI(1.02,1.73),P<0.05]、视觉障碍[RR=1.51,95%CI(1.22,1.87),P<0.001]、脑卒中史[RR=1.27,95%CI(1.08,1.48),P<0.05]、应用精神类药物[RR=1.32,95%CI(1.19,1.47),P<0.001]、平衡功能差[MD=-2.26,95%CI(-3.98,-0.55),P<0.05]、功能独立性差[MD=-14.69,95%CI(-18.19,-10.48),P<0.001]、计时起立-步行测试用时长[MD=2.99,95%CI(0.03,5.95),P=0.05]、跌倒恐惧、认知障碍和抑郁[RR=1.39,95%CI(1.24,1.57),P<0.001]有关。结论:现有证据表明,高龄、既往跌倒史、偏瘫、忽视、共济失调、视觉障碍、脑卒中史、应用精神类药物、平衡功能差、功能独立性差、计时起立-步行测试用时长、跌倒恐惧、认知障碍和抑郁是脑卒中病人发生跌倒的危险因素。Objective:To systematically evaluate the risk factors of falls in stroke patients and provide evidence for preventing falls in stroke patients.Methods:The literature on the risk factors of falls in stroke patients was retrieved from 7 databases including PubMed,EMbase,Web of Science,the Cochrane Library,CNKI,WanFang Database,VIP and CBM.RevMan 5.3 software was used to analyze the data.Results:A total of 20 articles were included and 32 risk factors were extracted.The final analysis showed that the occurrence of falls in stroke patients was related to old age[MD=2.37,95%CI(1.63,3.10),P<0.001],past fall history[RR=1.39,95%CI(1.09,1.77),P<0.05],hemiplegia[RR=1.25,95%CI(1.10,1.42),P<0.001],neglect[RR=1.69,95%CI(1.34,2.12),P<0.001],ataxia[RR=1.33,95%CI(1.02,1.73),P<0.05],visual impairment[RR=1.51,95%CI(1.22,1.87),P<0.001],stroke history[RR=1.27,95%CI(1.08,1.48),P<0.05],use of psychotropic drugs[RR=1.32,95%CI(1.19,1.47),P<0.001],poor balance function[MD=-2.26,95%CI(-3.98,-0.55),P<0.05],poor functional independence[MD=-14.69,95%CI(-18.19,-10.48),P<0.001],time spent in standing up[MD=2.99,95%CI(0.03,5.95),P=0.05]and walking test,fall fear,cognitive impairment and depression[RR=1.39,95%CI(1.24,1.57),P<0.001].Conclusion:Existing evidence shows that old age,previous fall history,hemiplegia,neglect,ataxia,visual impairment,stroke history,the use of psychotropic drugs,poor balance function,poor functional independence,the duration of time up-and-walk test,fall fear,cognitive impairment and depression are the risk factors for stroke patients to fall.

关 键 词：脑卒中 跌倒 危险因素 META分析 循证护理 

分 类 号：R473.74[医药卫生—护理学]