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目的跌倒致头创伤占老年人头创伤的60%以上。由于缺乏有关此类事件发生环境的客观证据,使得对其预防显得颇为困难。为了确定老年人跌倒后导致头创伤的频率和风险因素,调查者对两所老年公寓录像进行了分析。方法历时39个月,调查者从录像中发现共133位老年人发生了227起跌倒事件。采用有效调查问卷分析每起跌倒事件的相关机制以确定头创伤是否与上肢保护性反应及跌倒朝向相关。结果跌倒事件中,有37%的跌倒导致了头创伤,往往发生在乙烯树脂或油毡地面上。74%的跌倒导致了手臂创伤,但对头创伤发生概率的影响不大(P=0.3)。与后向跌倒相比,前向或侧向跌倒致头创伤概率明显上升〔OR分别为2.7和2.8;95%CI分别为(1.3,5.9)和(1.2,6.3)〕。侧向跌倒中,有36%的老年人向后旋转跌在地面上,从而减小了头创伤的概率〔OR=0.2,95%CI(0.04,0.80)〕。解释老年公寓的老年人跌倒后常发生头创伤,尤其是前向跌倒。除了手臂受伤外,跌倒过程中向后旋转可起到保护作用。加强上肢臂力及跌倒后旋转技术(功夫培训项目)的培训可减少老年人跌倒致头创伤。
The purpose of falling headache accounts for more than 60% of the elderly head trauma. The lack of objective evidence of the circumstances in which such incidents occurred made prevention quite difficult. To determine the frequency and risk factors that lead to head trauma after falls, the investigators analyzed the videos of two elderly apartments. Method lasted 39 months, the investigators found a total of 133 elderly people recorded 227 falls from the video. An effective questionnaire was used to analyze the mechanisms involved in each fall event to determine whether the head trauma is related to the protective response and fall orientation of the upper limbs. As a result, 37% of falls caused head trauma, often on vinyl or linoleum floors. Seventy-four percent of the falls caused arm trauma, but had little effect on the probability of head trauma (P = 0.3). The incidence of traumatic head injuries in the anterior or lateral fall was significantly higher than in the fall (OR 2.7 and 2.8, respectively; 95% CI, 1.3 and 0.9) and (1.2 and 6.3), respectively. In a side-down fall, 36% of the elderly spun back down on the ground, reducing the chances of head trauma (OR = 0.2, 95% CI, 0.04, 0.80). An explanation for the elderly apartment elderly people often fall after the first head injury, especially the forward fall. In addition to arm injury, the fall backwards during rotation can play a protective role. Strengthening upper limbs and arm rotation and post-fall rotation techniques (Kung Fu Training Project) training can reduce head injuries caused by falls in the elderly.