新型“防滑小红袜”对老年住院患者跌倒预防的临床研究

高燕飞 章妙玉 钟玲玲

[摘要] 目的 探讨新型“防滑小红袜”对老年住院患者跌倒的预防作用。 方法 选择2015年12月～2017年6月在本院老年科、心血管科和神经内科住院的老年患者600例为研究对象，随机分为试验组与对照组各300例。对照组给予常规干预，试验组在此基础上应用新型“防滑小红袜”，比较住院期间两组患者跌倒发生率、跌倒伤害程度，预防跌倒知识、态度及行为评分。 结果 试验组住院期间1例发生跌倒，发生率0.3%，对照组9例发生跌倒，发生率3.0%。两组比较差异有统计学意义（P<0.05）。试验组1例跌倒，为1级，对照组3例1级，4例2级，2例3级，差异有统计学意义（P<0.05）。干预后，试验组的预防跌倒知识、态度、行为得分均显著高于对照组，差异有统计学意义（P<0.05）。 结论 老年住院患者应用新型“防滑小红袜”能够有效预防住院期间跌倒发生率，降低跌倒伤害程度，改善预防跌倒知识、态度及行为。

[关键词] 防滑小红袜;老年住院患者;跌倒;预防

[中图分类号] R472          [文献标识码] B          [文章编号] 1673-9701（2019）09-0153-04

[Abstract] Objective To explore the effect of the new type "slip-resistant small red sock" on the fall prevention in elderly inpatients. Methods A total of 600 elderly patients who were hospitalized in the Department of Geriatrics， Department of Cardiology and and Department of Neurology in our hospital from December 2015 to June 2017 were selected as study subjects and were randomly divided into the experimental group and the control group， with 300 cases in each group. The control group was given routine intervention， and the experimental group was given the new type "slip-resistant red small socks" on this basis. The incidence rate of falls， the degree of fall injury， and the scores of the knowledge， attitudes， and behaviors of fall prevention were compared between the two groups during hospitalization. Results One case fell during the hospitalization in the experimental group， and the incidence rate was 0.3%， while in the control group， 9 cases fell， and the incidence rate was 3.0%， the difference between the two groups was statistically significant （P<0.05）. One case fell in the experimental group， which was level 1， in the control group， 3 cases were level 1， 4 cases were level 2， and 2 cases were level 3， and the difference was statistically significant （P<0.05）. After the intervention， the scores of fall prevention knowledge， attitude and behavior in the experimental group were significantly higher than those in the control group， and the differences were statistically significant（P<0.05）. Conclusion The application of the new type “slip-resistant small red socks” for the elderly inpatients can effectively prevent the incidence rate of falls during hospitalization， reduce the degree of fall injury， and improve the knowledge， attitudes and behaviors of fall prevention.

[Key words] Slip-resistant small red sock; Elderly inpatients; Fall; Prevention

老年住院患者跌倒常常涉及多個专科，以内科老年住院患者居多。老年住院患者容易跌倒与患者机体衰老、神经系统退行性改变、控制能力下降等有关。跌倒影响老年患者的健康，甚至危及生命，是最常见的医院内不良事件。老年人跌倒后容易导致髋部骨折，6个月内死亡率高达20%～24%，50%丧失独立生活能力。根据美国疾病预防和控制中心统计，65岁以上老年人中，每年约有1/3的人曾经跌倒[1]。我国已于1999年进入老龄社会，是世界上老年人口最多的国家。民政部2014年6月发布的《2013年社会服务发展统计公报》显示，截至2013年底，全国60岁及以上老年人口20 243万人，占总人口的14.9%，其中65岁及以上人口13 161万人，占总人口的9.7%[2]。高茂龙等[3]通过循证医学Meta 分析的方法，得出我国老年人跌倒的发生率是18.3%。随着老年人的增加，跌倒将会对医疗服务体系造成更严重的经济冲击。鞋过大或鞋底摩擦力小是滑倒的主要原因，“穿着适宜的鞋具”已被作为一个要素列入各国的跌倒干预技术指南。澳大利亚维多利亚州采用“防滑袜”和一系列的运动干预措施，让高风险患者在住院期间穿“防滑袜”，并结合相关的运动、走路技巧培训，确保患者住院期间的行走安全。有研究认为对老年住院患者采用新型“防滑小红袜”为主的综合干预措施，有可能大幅度减少跌倒的发生，并能减少因为跌倒而产生的一系列的医疗护理费用和法律纠纷。本研究将新型“防滑小红袜”用于老年住院患者，探讨其对老年患者跌倒的预防作用，现报道如下。