维持性血液透析患者发生跌倒的危险因素的Meta分析  

Meta-analysis of risk factors for falls in patients with maintenance hemodialysis

作　　者：刘雪琴 刘晓辉 车旭 LIU Xueqin;LIU Xiaohui;CHE Xu(School of Nursing,Sanquan College of Xinxiang Medical University,Xinxiang 453513,Henan,China;Henan Hospital of Traditional Chinese Medicine&The Second Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450002,Henan,China)

机构地区：[1]新乡医学院三全学院护理学院,河南新乡453513 [2]河南省中医院,河南中医药大学第二附属医院,河南郑州450002

出　　处：《护士进修杂志》2024年第8期817-823,共7页Journal of Nurses Training

基　　金：河南省中医药文化与管理研究项目(编号:TCM2023009);教育部学位与研究生教育研究课题(编号:MSC8)。

摘　　要：目的系统评价维持性血液透析(MHD)患者发生跌倒的危险因素。方法计算机检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library和Embase中关于MHD患者发生跌倒的危险因素的研究,使用RevMan 5.4软件进行meta分析。检索时限为建库至2023年7月1日。结果最终纳入19篇研究,总样本量为107641例。17项因素中,10项影响因素(P<0.05),包括危险因素:年龄[OR=1.03,95%CI(1.00,1.05),P=0.002]、糖尿病[OR=1.97,95%CI(1.42,2.73),P<0.001]、透析龄[OR=2.23,95%CI(1.68,2.98),P<0.001]、透析相关低血压(IDH)[OR=1.93,95%CI(1.88,1.97),P<0.001]、衰弱[OR=1.64,95%CI(1.43,1.88),P<0.001]、跌倒史[OR=1.71,95%CI(1.43,2.05),P<0.001]、甲状旁腺功能亢进[OR=1.31,95%CI(1.15,1.49),P<0.001]、听力或视觉障碍[OR=1.58,95%CI(1.24,2.01),P=0.002]、平衡与步态[OR=2.23,95%CI(1.54,3.25),P<0.001];保护因素:血清白蛋白(Alb)[OR=0.89,95%CI(0.83,0.95),P=0.001]。结论年龄、糖尿病、透析龄、IDH、衰弱、跌倒史、甲状旁腺功能亢进、听力或视觉障碍及平衡与步态均为MHD患者跌倒的危险因素,Alb为MHD患者跌倒的保护因素。Objective To systematically evaluate the risk factors of falls in maintenance hemodialysis(MHD)patients.Methods The studies on the risk factors of falls in MHD patients from China National Knowledge Infrastructure(CNKI),Wanfang,VIP,CBM,PubMed,Web of Science,Cochrane Library,and Embase were searched by computer,and RevMan 5.4 software was used for meta-analysis.The search time limit was from the establishment of the database to July 1,2023.Results A total of 19 studies were included,with a total sample size of 107,641.Among the 17 factors,10 influencing factors(P<0.05)included(1)Risk factors:Age(OR=1.03,95%CI was from 1.00 to 1.05,P=0.002),diabetes(OR=1.97,95%CI was from1.42 to 2.73,P<0.001),age of dialysis(OR=2.23,95%CI was from 1.68 to 2.98,P<0.001),related dialysis hypotension(IDH;OR=1.93,95%CI was from 1.88 to 1.97,P<0.001),frailty(OR=1.64,95%CI was from 1.43 to 1.88,P<0.001),history of falls(OR=1.71,95%CI was from 1.43 to 2.05,P<0.001),hyperparathyroidism(OR=1.31,95%CI was from 1.15 to 1.49,P<0.001),hearing or visual impairment(OR=1.58,95%CI was from 1.24 to 2.01,P=0.002),balance and gait(OR=2.23,95%CI was from 1.54 to 3.25,P<0.01);(2)Protective factors:serum albumin(Alb;OR=0.89,95%CI was from 0.83 to 0.95,P=0.001).Conclusion Age,diabetes,age of dialysis,IDH,frailty,history of falls,hyperparathyroidism,hearing or visual impairment,and balance and gait were all risk factors for falls in MHD patients,and Alb was a protective factor for falls in MHD patients.

关 键 词：维持性血液透析 跌倒 危险因素 META分析 护理 

分 类 号：R473.58[医药卫生—护理学] R586[医药卫生—临床医学]