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维持性血液透析患者严重跌倒的发生、并发症及危险因素

2012-04-10 范振光 肾脏病与透析肾移植

    我们中心所有维持性血液透析(MHD)的患者参加了此调查,首先进行基准的行为导向的流动性评估试验(POMA)及跌倒风险因素纪录。 我们把急诊入院的摔伤定义为严重摔伤并记录在案。       入组患者共有84名(平均年龄69.5岁,最小26岁,最大85岁),透析前POMA分数低(中位数20,最高26,最低5),20.6个月(142.2病人年

    我们中心所有维持性血液透析(MHD)的患者参加了此调查,首先进行基准的行为导向的流动性评估试验(POMA)及跌倒风险因素纪录。 我们把急诊入院的摔伤定义为严重摔伤并记录在案。       入组患者共有84名(平均年龄69.5岁,最小26岁,最大85岁),透析前POMA分数低(中位数20,最高26,最低5),20.6个月(142.2病人年)的随访过后,24例患者发生 31次严重跌倒(占28.6%;发病率为0.22/病人年),其中并发骨折率为54.8%。 在单因素分析中,年龄、过去跌倒史、营养不良、抑郁症都与严重跌倒相关,POMA得分则不是。 POMA得分> 21者有82%的阴性预测值。此研究发现,MHD患者发生严重跌倒是很常见的,而且严重跌倒后> 50%的情况下会导致骨折。这与年龄、过去跌倒史、营养不良和抑郁有关。       虽然与没有发生跌倒者相比,跌倒者的POMA得分较低,但这项研究中POMA得分却不是严重跌倒的独立预测因素。 这些数据可能有助于对患者跌倒发生风险进行分层,以防止这一人群跌倒的发生。

文献来源:http://www.medlive.cn/literature/31311

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    2013-01-06 丁鹏鹏
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    2012-04-12 habb
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